So I started taking Truvada

For starters, you have to forget how old you are.

How odd, even for an R1. Why? 50 year olds don't have sex? What planet do you live on?

Sex is wasted on the young.

I'm very cautious about PrEP. I'm glad it's working for people, but it's not going to work for me just yet. Among other things, it won't help protect against the entire panoply of other STIs that can be transmitted without using condoms.

I'm also concerned about the long term effects of taking very potent medications. The research has shown that if you're on PrEP, miss a dose or two, and seroconvert, then the standard cocktail will no longer be effective.

Finally there's the pressure thing. Ever since it's been widely available, more and more bottoms I've met on PrEP have pressured me to top them bareback even though I've made it clear that I'm just not comfortable doing that. I respect other people's sexual choices, and I'm finding it irritating that it isn't always reciprocated.

OP, are you saying you are on Truvada but having anal sex without a condom...or with? Please clarify so we can properly opine.

Thank you.

Keep an eye on your liver OP

This is an excellent development, and I applaud your liberation, OP!

One of the interesting aspects of PReP is the implied warranty of negative status - if you are on PReP you are by definition almost with certainty negative. This makes a third class of sexual prospect - positive, unknown (presumed negative) and known negative.

In the real world condoms use has been declining because they think they can reliably serosort.

Not liver R5 but kidneys are a problem in .5% of patients. Testing for this is part of the regimen.

Oh hurray, another sex shaming thread.

I have an appointment next week to go on the drug. It requires testing up front to make sure you're negative, a one month test to make sure liver and kidneys aren't being impacted, and continued tests of blood and urine as well as full std testing every three months. If there are kidney problems, the problems show up quickly and function fully returns when you go off the drug.

Lots of numbers are thrown around but those who take the pill daily are virtually immune to HIV. There are multiple studies going on around the world and three in Los Angeles. As far as I know, there haven't been any infections in those who follow the rules (giving the drug 30 days to build up in your system and taking the pill daily).

I have spoken to five friends on PreP and all are relatively responsible guys who did not always use condoms as tops before the drug. All of them are relatively low risk for HIV but low risk isn't zero risk and they all cite the relief they feel not having to worry about HIV. None have drastically changed their sex lives or behavior. There is just less fear. And the promise they will remain negative if they take the pill everyday.

For many of us who have remained negative, there is so much fear surrounding HIV. That's part of how some of us remain negative. I'm relatively low risk, but I've had three sexual partners in three years who seroconverted around the time that I had sexual contact with them (or that's my best guess based on their online profile hiv status update--and those are the three I know of). In each case, I used protection or engaged in low to no risk behavior but condoms aren't 100%. I'm curious what its like to take an HIV test and not need a Xanax beforehand. I'm also curious what its like to bottom during bareback sex. As a bottom, I've had one bareback partner and he never came inside of me. As a top, I'm looking forward to using condoms less often. They don't work for me. I'm also happy about the fact I won't need to limit my dating pool to guys who are negative. Part of staying negative was shutting out a lot of great potential mates who happened to already be infected. Part of limiting my risk was deciding that I would not be in a relationship with someone who is "undetectable" because guys who are can go back to being detectable until meds are adjusted. With PreP, I can think differently about the situation now.

Right now there are two categories of men getting on the drug. The first is the parTy guys who have multiple partners in a month (5-15 or more), use drugs and alcohol to excess, bareback regularly, and are part of the free health clinic systems that are putting them on this med if they're still negative. When you hear about infections on the drug, my guess is you're hearing about them because they're not responsible enough to take a pill every day.

The other group is educated white men with great insurance or those who can afford large co-pays. They're signing up in droves.

My one minor concern is the long term effects that remain unknown. I'm not sure how long I'll stay on it. I don't have to stay on it any longer than I need to. For now, I'm happy to take it one month at a time and go from there.

[quote]The other group is educated white men

[quote] The research has shown that if you're on PrEP, miss a dose or two, and seroconvert, then the standard cocktail will no longer be effective.

Chilling. Here's hoping that HIVE vaccine gets here quick.

Does PrEP cause facial wasting/lipodystrophy? Apparently the component drugs of Truvada do, but no one has mentioned this in connection to PrEP itself. Am I the only one interested in asking the hard questions?

It sounds like it could be a solution to protect some people but what about Hep C transmission? That is also a pretty devastating illness.

I won't take this dangerous drug, but I love raw fucking the men who do.

PrEP can effectively prevent HIV infections - that is a great thing!

If you go on it with the intention to bareback with relatively unknown people and relatively frequently - e.g. all this talk by the OP about "freedom" "liberation" and "no fear" - you risk contracting multiple STDs including serious ones. Hep C is not curable, true, but even rich countries are balking at the price of the cure and not offering it to everyone infected.

STD rates are out of control in cities with critical masses of MSM who are barebacking...

Yes you won't likely get HIV. Win!

But the next hideous STD is around the corner. Such as drug resistant clap.

typo - Hep C is NOW curable, but.....

Hep C is transmitted by blood. While possible to transmit sexually, that isn't a common route of transmission and it really isn't considered an STI

Question for OP and other users of Truvada:

Do you also wear condoms, as recommended?

I already know the answer, which is why I roll my eyes whenever people who take Truvada claim their motivation is peace of mind. Um, no. You want to be a ho.

Wrong R17. Ask any ID specialist in a big city like Berlin London NYC SF. Hep C is a sexually transmitted disease for MSM and not just for fisters. And infections come in waves. As usual, CDC is way behind the cutting edge epidemiology.

Actually, R19, I've had that very conversation with my very own ID specialist in my very own big city NYC, who says that he has rarely seen cases of sexually transmitted Hep C among the 3000+ MSM that he follows in his practice. But by all means don't let facts get in your way, you know what you know.

What is an MSM?

[quote] The research has shown that if you're on PrEP, miss a dose or two, and seroconvert, then the standard cocktail will no longer be effective.

Does anyone know what studies R3 is talking about? I did a quick google search and can't find any examples.

Well my ID in Geneva Switzerland tells me the opposite so I guess its a muddy area. R20

MSM = Men who have sex with Men R21. Its a way to make a category that includes men who do not identify as bi or gay.

I don't have a problem with PrEP. I think the OP's argument and rationale is poorly done.

r9, are you sure you're not a shill for Gilead? Because there have been similar threads in the past, and there's always a poster like you who make the same marketing bullet points that you did, disguised as a 'real life' post. Here's some advice to make your shill posts more believable:

1. Don't try to use lingo you think the gays use, e.g. 'The first is the parTy guys ...'

2. Stop hammering home the point that 'part of staying negative was shutting out a lot of great potential mates who happened to already be infected." Nobody thinks that way, unless they're trying to brainwash HIV- guys into taking a risky drug. None of us are thinking 'Gee it's so unfair that I can't expand my dating options to include guys who are HIV+'. Some of us get involved with guys who turn out to be positive and go from there. That can be dealt with without truvada.

3. Stop using so much insider drug company data. That's a giveaway. How would any of us know who is 'signing up in droves' unless we worked in Gilead's marketing dept?

Your post is so transparent maybe you should try again on a new thread.

I'm too poor for it

r12, I don't think they know that yet, but we will soon enough (as this is a big drug experiment). There's no reason to think that the same drug in one mix won't cause the same side effects in another. Repackaging it as PREP won't remove the side effects.

One thing they won't tell you about is the gas/diarrhea which is a known side effect.

Jesus - some of you guys act like wearing condoms is like a torture device. HIV is one worry among many - I've had friends contract syphillis and Hep C - fucking not fun. And they weren't particularly sexually active guys.

There's just no safe way to be a whore without condoms. Ask actual whores. Jesus some of you are so stupid.

I've been on it for awhile now. Love it. Peace of mind is so freeing. I am one of those people who haven't experienced any side effects whatsoever. It's kind of weird. I will never understand the people who are against this drug. It is just another tool in the tool chest. If you don't want to take it, then don't take it no need to trash those of us who are on it.

Nobody is trashing you r28. Glad you 'love it'. Peace of mind is so freeing but also kind of illusory, as other people upthread have noted, there's a lot you can get that Truvada can't prevent.

I'm not against the drug, i'm against Gilead's marketing efforts which are directed at telling HIV- guys they can now take more risks. The official line is to use it with condoms, but as this thread proves, the real sell is that you can toss the condoms.

I also just don't want to take a prescription that is not required. Particularly one for the rest of my life. Who knows what kind of damage can be created?

I've managed to stay negative for the past 20+ years without it - so I will continue to keep acting responsibly instead of buying an expensive medication.

There are two ways to look at this.

One, from an individual level and two, the general population.

I'm not going to engage in this childish conversation about whores and sluts and Truvada.

But from the public health and general population perspective - the drug will probably end up being an effective tool. The goal is to reduce the percentage of the population who are HIV+ and thus reduce transmission and new infection rates. Truvada will do that.

Since tops/insertive partners are at a lower risk for HIV should they even consider PREP given the possible side effects? Is it worth it?

[quote]But from the public health and general population perspective - the drug will probably end up being an effective tool.

That is ONLY if everyone who takes it never misses a dose. My worry is that people get lax about their drug regimen. A lot of guys who are taking risks with HIV now also have substance issues. This is not the most dependable subgroup in terms of sticking to a medication schedule. Skipping does will help new treatment-resistant strains of HIV emerge. This is a major concern.

They should not be targeting the 'worried well' population who are already doing well controlling HIV. It's a pretty small wedge of MSM who are the problem.

'Skipping does' should be 'skipping doses' ^

R33 - I don't think you have data to support your conclusions. But go ahead and show your work.

There's no data because this is still a big experiment r35. The potential for creating a treatment-resistant superstrain of HIV is not a conclusion, it's a concern. We know this happens, e.g. when people stop taking a full course of antibiotics because they feel better. There's no reason to think the same won't happen with truvada taken as prep. Especially because, as noted above, the highest risk groups will probably also be the least likely to adhere to their drug regimen.

I could give fuck all about HIV; I never had and never will have anal sex, and have always tested HIV-, and I'm in my mid-40s. I did just get a lovely call from my STD testing clinic, though,that I tested positive for herpes. Oh joy! But at least I don't have HIV, because that's the ONLY thing that matters, right??? {huuuuuuuuuge eye roll}

The "worried well" are not really doing that well at preventing HIV transmission as is proven by the continued HIV infection rate. People think they are assessing risk intelligently but they are not. In the last few years in nyc I have been the sole advocate for condoms in virtually every sexual situation I have been in. Safer sex these days is more like "are you poz? No? good the we don't need to worry."

Truvada is a hell of a lot more effective than that line of thinking.

The copay is $40 on my "bronze" obamacare plan. I take the pill every day although it is pretty forgiving of occasional skipped doses. I have had zero side effects. I have not become a "load taking whore" as a result of taking the drug.

I no longer worry about the HIV status of my partners at all and I have a very effective fallback (actually better that condoms statistically) when we don't use them.

As for all the "what about xyz sti" arguments - condoms don't really help us there. I have had hep vaccines of the ones we have vaccines for. At least if you have sex with "Truvada whores" the are regularly tested for everything.

Wanting worry free sex is not a moral failing.

My insurance covers the prescription -- $40 a month, but not the required labs -- $795 last time I went.

[quote]I take the pill every day although it is pretty forgiving of occasional skipped doses.

What is pretty forgiving? Have you told your doctor you have skipped doses?

What I have never understood is why some of you hold gay men in such little regard that you just assume that they will not be following directions and slacking off on required follow ups. The ultimate problem here is you have no respect for your fellow gay men.

r40. Did I say *i* skipped doses? No I said I take it every day. My dr however is the one that said take it every day but it remains effective if taken 4times a week. Im used to taking pills every day (cholesterol) so it's not a problem.

R36 - you have to move your thinking out of the world of speculation and into the world of science. Modern medicine is about balancing risks and benefits. Yes it is remotely possible that someone taking Truvada who becomes infected while on the drug could develop an drug resistant strain of HIV. Just like someone who is HIV+ and being treated with the latest cocktail runs the risk of developing a drug resistant strain of HIV. But the benefits far outweigh the risks.

You're conjuring horror stories not based on science. It's not that much different from claiming HIV is punishment from God.

R38 it is not the "worried well" who are becoming newly infected. Never has been. We know with decades of evidence that condoms used correctly and consistently are a cheap and wholly effective way of preventing HIV transmission. About Truvada (and all it's lookalikes coming down the pipeline) we know ... not so much.

r43 i'm not conjuring anything, do some research and you'll see the public health concerns are out there. Your claim 'HIV as punishment' remark is just a low blow, and frankly, stupid and inept.

Gay men are part of a big $$$ pharma experiment. Like any other drug there are risks, some of them unknown. Your risk/benefit analysis is skewed when you are talking about giving powerful antiviral drugs to otherwise healthy men, solely as prevention. This hasn't really been done before for HIV. Answer the questions about facial wasting and diarrhea if you want to talk about risks and benefits.

NYC too R38 and we must have different sex partners because in my experience, most guys are still insisting on condoms. I am a top and I always wait for the bottom to tell me to put a condom on. If he asks me to fuck him bare, I stop and leave because I don't want to take chances, but that does not happen very often.

r43's tactics are very similar to those of the shill from the last thread on prep: muddle the issue, don't answer questions, hook negative associations on anyone who dares question that truvada prep is something we should all be doing. Hmmmm.

[quote]and I have a very effective fallback (actually better that condoms statistically) when we don't use them.

WHO WOULD KNOW THIS? except a Gilead shill as r38 clearly is.

Who would know this? Anyone who has read the many many articles on the subject and my doctor. The big pharma conspiracy angle does not really hold any water. This is a personal health issue that people should be talking about but here you are trying to shut down the conversation with ad hominem attacks. Believe what you will.

When someone says "I no longer worry about the HIV status of my partners at all" as a drug testimonial, and then quotes stats on the drug's efficacy vs condom use, it's a big red flag.

No one is trying to shut down the conversation. You're just unable or unwilling to answer questions from anyone who is skeptical of your ad copy. I'm glad you used the term 'ad hominem' correctly, because in the past thread on this, it tripped you up a few times. Someone dig up that thread please.

R45 - my comment was not out of line. I have done the research. Yes of course there are side effects. In less than 10% of people taking the drug. So you have to stop taking the drug. You are making the assertion that the risks of a drug resistant HIV strain resulting from Truvada by far outweighs any possible public health benefits. I can't find any evidence to support that conclusion. Go ahead and show us the research that supports your conclusion.

Back to my comparison. It's valid. Both opinions have no basis in science or modern medicine, but are driven by some warped morality.

As far as your question about any other disease being prevented this way - perhaps you have an example of a similar disease that we are ignoring and not trying to prevent? On the other hand drugs are used in the prevention of Malaria.

r38 are you saying you use truvada with condoms or without? What do you mean by 'I have a very effective fallback (actually better that condoms statistically) when we don't use them.'

What does this mean?

Anyone remember after the last thread how the word Truvada could not be posted on DL for a few months? And now, just as mysteriously, it can. And guess who's back with us ...

How many people taking truvada for prep get facial wasting?

I use coconut oil. It's natural and proven.

Truvada alone does not cause "facial wasting"

That's interesting r57 because this page at link says otherwise.

"HIV drug regimens containing nucleoside reverse transcriptase inhibitors (NRTIs), including Truvada, can cause increased fat levels (cholesterol and triglycerides) in the blood, and abnormal body-shape changes (lipodystrophy; including increased fat around the abdomen, breasts, and back of the neck, as well as decreased fat in the face, arms, and legs). These side effects of HIV drug therapy are reviewed in our lessons on Lipodystrophy, Facial Lipoatrophy, and Risks To Your Heart (Hyperlipidemia)."

Give it a rest, r49. No "shill" would waste their time on a low traffic site like DL. Some people are just more informed than you.

[quote]Ever since it's been widely available, more and more bottoms I've met on PrEP have pressured me to top them bareback even though I've made it clear that I'm just not comfortable doing that. I respect other people's sexual choices, and I'm finding it irritating that it isn't always reciprocated.

FANK YOU! Yes, the SAME thing has happened to me twice...and I'm like - no - I don't want whatever else is in your ass (potentially) and I want to use a condom. And one flat-out refused... but he gave really good head and was pretty fucking hot ginger Atlanta beef (visiting - hey) - so I got over it, but still. I would totally have fucked him.

Also, I know of a guy who got HIV SUPPOSEDLY from topping another guy who also had a bunch of loads in his ass that were poz (at a bathouse or something). It's hard for me to believe that... especially since this guy is also a big bottom, but another one of my friends "confirmed" that was true. Seems very unusual.

I had to take Truvada + Isentress once for PEP and my liver enzymes slowly climbed until I stopped it at 28 days. My doc said it was the Truvada, not the Isentress that did that.

I'm surprised more people don't just do safe things and get PEP on the rare chance something goes awry.

Life of a gay man is a dangerous one

[quote]Life of a gay man is a dangerous one

yes, that's why I transitioned

[quote]I'm surprised more people don't just do safe things and get PEP on the rare chance something goes awry.

Because that would not be very lucrative. The ka-ching! plan is to have every HIV- man believing that this $13K pill is the best insurance against HIV. Which is idiotic as HIV is quite easy to prevent without it.

R63 Bravo to you. Gilead Sciences (the big pharma behind this) needs to get its investment back. Good thing horny men are usually blinded by facts huh?

No excuse for gay men getting infected. Totally preventable.

So was your birth r65, but you still happened.

Why get so angry R63?

If condoms were the be all end all then HIV would have been contained and pretty much a relic of the past here in 2015. Instead of coming up with big pharma conspiracies, why not just embrace that we have another weapon in the fight against this disease. Condoms will be the choice for some, while Prep will be the choice for others. And this doesn't even include those who don't practice anal or who are abstinent.

Many of the same excuses for why the birth control pill was bad have been trotted out for this debate on Truvada. Celebrate choices and pick the one that works best for you. No need to yell and holler about someone else's.

I would never take that pill. I would never TRUST some pill to keep me safe from HIV. Period. Ever. And it "might" wreck my liver or god knows what else? Please. Keep it. I will continue to use condoms if and when the situation calls for it. Easy peasy. But to each his own.

geez what a rat fuck

R68, I agree with you. I would never trust a pill to save my life.

I came of age in the early 80s -- I knew about the closet and God bless Phil Donahue for doing shows on married gay men and gay men and 'how things were changing'.

Then along came AIDS. I used to think that if you were gay you'd get AIDS, you wouldn't need to have sex, you'd just develop it, like it was part of the gay gene or whatever.

I made a choice -- very little sex and what sex I had was safe. Forget the fact that I'd always fall for guys who were either wrong for me or 'out of my league' (I fucking hate that expression, btw. I'm hung like a horse, ironically; to some, that makes me a catch.)

I really pray that there's reincarnation. I have no woes about coming back as a gay person, but I'd just love to come back as someone more secure and more hot (in that order). That way I can walk into a bar on a Friday with new condoms in my wallet and hope to get lucky.

R24 - I'm the guy you called a shill. I'm not. I've had a year to think about this since my first friend went on PreP. I also needed to start on two other medications (one permanent, one for a few weeks) that have side effects so decided to hold off on Truvada until I could test liver/kidneys and know which drug was causing a problem if any did.

During that time I talked to my friends about their thoughts. Several were already on it or went on it. I also learned there are three studies going on in Los Angeles;: USC, UCLA, and the LAGLBT center. I know two people in the UCLA study. One in the USC study. And before my insurance got worked out, I was using the LAGLBT center for primary healthcare visits so I spoke to a nurse there about PreP (since i figured they'd be far more knowledgable and have more data than any primary care Dr. I'd end up with once insured--they're running study #3). Their study is only for the "parTy" guys/super high risk guys who have 5-15 partners per month. USC and UCLA are giving the drug for free and last I heard, had closed the study for white guys but were still looking for black and hispanic subjects. (I'm not a scientist but I did just watch 26 eps of Masters of Sex in 2 weeks, sorry if my lingo sounds too insider).

On your other point:

"Stop hammering home the point that 'part of staying negative was shutting out a lot of great potential mates who happened to already be infected." --I just joined Tinder for the first time. I've been using online dating for ten years, it was weird for me to not have to put too much thought into a guy's HIV status. I used to automatically rule out dating guys w/ hiv. I definitely was one of those guys who wrote "neg for neg" a few years ago.

"None of us are thinking 'Gee it's so unfair that I can't expand my dating options to include guys who are HIV+'. Some of us get involved with guys who turn out to be positive and go from there. That can be dealt with without truvada." I am!!!! I don't want to be glib, so I'll suggest that's how you've dealt with the threat of hiv, I chose to deal with it differently. I am not saying I'm right, I understand the risk of me contracting HIV is low with an undetectable partner, but I'd be fucking terrified to have unprotected sex with someone "undetectable" without Truvada. I will not do it. That is my right. Undetectable is not a permanent status--And more gay guys should be aware of that.

"How would any of us know who is 'signing up in droves' unless we worked in Gilead's marketing dept?" I'll refer you back to the USC/UCLA studies that weren't looking for more white subjects. I am also on Grindr and Scruff in LA, I've had months to see who's mentioning it in their profiles--on scruff, guys list their occupation, in other cases, I've dated or have met them. Totally anecdotal. I just threw that in because I find it interesting and in the articles I've read and the documentary I watched, ethnicity, education and $$ seem to be a big factor here. I recently spoke to a 21 year old gay Hispanic kid from about 20 miles outside of LA--He'd never even heard of the drug.

"Your post is so transparent maybe you should try again on a new thread." You're wrong, but I did post weeks ago with similar information.

I'm just excited about my sex life being more like my straight single friends. Condom use when appropriate, making informed decisions about not using condoms with people you know, trust, and who get tested or know their status and are being treated. Before now, my informed decision was to use condoms at all times. I don't have to anymore. I am very excited to see what that feels like.

r72,

To quote, place [quote] and a space in front of the text you want to quote.

So, moobs gut and backfat are considered medical side effects?

Thank ACA I can only afford condoms.

After all the accusations of shilling on this thread, it's funny that the only finger pointing is limited to big Pharma and not toward those who parrot the talking points of the Aids Healthcare Foundation and Michael Weinstein. And yet who has been at the center of controversy about making money off of AIDs? Why, it's the AHF and Michael Weinstein, currently under investigation for Medicaid fraud.

And, of course, I hit the nail on the head at R8. Twenty four hours and 60+ responses later, and it's all about Truvada whores, side effects, and how HIV is so easily prevented... and not, saving one reply, about how Truvada is just another tool in the box used to prevent the spread of HIV. so let's look at these accusations and deconstruct the arguments.

Humans are sexual beings. In fact, of all of the human activities, sex ranks among the five must-haves in order to live a fulfilling, complete life. And, men are hard wired for sexual activity. So of course gay men are going to be more promiscuous (a word I hate, but it is aptly used in this context) than average; just look at studies on bisexual men who routinely come back to the fact that obtaining sexual contact with another man is far easier, more available, and less complicated than heterosexual contact. To suggest that gay men should just stop having sex is a fools errand. Let's approach this from a much more realistic angle, to perhaps suggest that MSM use all of the tools available to them, from condoms to PrEP.

Second, we all know that drugs have side effects. Some side effects are quite serious. My mother was almost killed by some high powered antibiotics her physician put her on; does that mean we should tell people to not take antibiotics? My heart doctor put me on statins to reduce cholesterol, and within two weeks I was having trouble getting out of bed the side effects were so bad (horrendous joint and muscle pain, headaches, nausea) that I had to stop taking the drug. Does that mean we should go around and tell everyone to stop taking statins?

Of course not. What it does say is that anyone who starts Truvada should monitor for side effects closely, whether in the short or long term, and if the side effects outweigh the benefit of the drug, stop taking the drug. And this includes the horrors of facial wasting and lipodistrophy, which I can't believe are the major concerns of the anti-PrEP trolls.

Third, the idea that PrEP and/or drug therapies are going to bring about super strains of HIV is almost farcical. HIV is not comparable to other viruses. That's part of the reason HIV has been such a devastating disease; protocols and known science have been almost impossible to apply toward understanding and curing HIV. As my primary care physician flat-out told me, the likelihood of HIV mutating into another super strain or drug resistant form is almost impossible. I quote "almost" because statistically it is possible -- we don't know all there is to know about HIV. Nevertheless, as my doctor anecdotally quipped, if a super strain was likely, it would have already shown itself. We are 30+ years into this epidemic, after all.

However, when used with even the least of care, Truvada can make a difference on HIV transmission. To those who suggest that a missed dose or two combined with otherwise unprotected sex is going to result in seroconversion, all I can say is that your research is incomplete. The way that all of the HIV cocktails work is through building a progressive defense. Yes, if you're going to take Truvada as your sole layer of protection against HIV, then you should adhere to the protocols as closely as you possibly can. If that sounds like shilling for a drug company, I'm sorry that science is your bugaboo. Really, is taking a single pill once a day too much to ask? You can't just say, "I eat breakfast/lunch/dinner once a day, so I'll just make it a habit to take this pill when I do that?" Jesus, are you so lazy that you forget to brush your teeth too? Or does mommy have to remind you?

Now, back to the sex shaming...

Please put your personal feelings aside for a moment and consider the following fact. About 30 years after the height of the aids crisis, only one in six sexually active gay men use condoms absolutely all the time. And while very effective, condoms still have a failure rate.

Truvada is a tool some of us can use to remain negative. It's not for everyone.

All sexually active hiv- gay men have the right to know this pill exists, how it works, what it does and doesn't protect from, and hopefully soon the right to access the drug despite whatever state you live in or insurance you have.

This drug is revolutionary. Things may change because of it (as noted in the concerns mentioned on this board). But it's here and for some of us, we will finally be able to have an active and fulfilling sex life without the threat and fear of hiv. I don't know what that is like yet but I'll be sure to let you know once I'm on the drug myself.

[quote]Nevertheless, as my doctor anecdotally quipped, if a super strain was likely, it would have already shown itself. We are 30+ years into this epidemic, after all.

Sorry, that sounds like the beginning line of a plague movie. "Mom get hip; it's the 70s.

R22, thanks for your inquiry. I live in SF and went to a public meet-up with HIV prevention experts to hear about PrEP, and the consultant who spoke to us explained this fact. So I don't have any of the scientific research to back it up, but I did hear it from an expert in the field.

You're a whore, R37.

Don't mistake this as a musical pill, that let's you go out & have risky sex, with every person you see. From Try ads site

Just taking TRUVADA may not keep you from getting HIV-1. You must continue using safer sex practices while you are taking TRUVADA to reduce your risk of getting HIV-1. To further reduce your risk of getting HIV-1: Get tested for other sexually transmitted infections. Other infections make it easier for HIV-1 to infect you. Get information and support to help reduce risky sexual behavior. Have fewer sex partners. Do not miss any doses of TRUVADA. Missing doses may increase your risk of getting HIV-1 infection.

HIV medicine has horrible side effects. I can spot a poz face any day

I have a good friend who does not have poz face but he has, after several years now (about eight) on the meds, developed a bit of a belly. Not a crix belly, per se, but his physique is "distorted," for lack of a better word. He is not even yet 50 but his body is beginning to look "wizened," like an elf or a munchkin. Legs are getting thinner and his stomach protrudes a bit. I could never tell him ever ever but I notice it every time I see him. His numbers have been okay for years but he has stomach trouble, too. Gastrointestinal issues. Pancreatic issues. He has had pancreatitis at least three times in the past five years. His health is, of course, compromised. No matter how well he is living with HIV. And he is. But he has also not had a date since he was diagnosed. I think he has given up on men and that is tragic to me.

HIV is not JUST a "manageable" disease. It is horrific. No longer a death sentence. It is now a life sentence.

R82,that is so sad!

So, the miracle of masturbation is still sex with a man, right? Talk about your worry-free sex.

[quote]You must continue using safer sex practices while you are taking TRUVADA to reduce your risk of getting HIV-1.

It is a joke that Gilead/Truvada says that. Everyone knows the whole point of Truvada is so you can ditch the condoms. If you use it with condoms there's no benefit at all.

They'll never admit this, of course, but it's what they're selling.

R60, glad I'm not the only one!

Sorry but I prefer not being a lab rat for big pharma.

But r87! It's a new tool in the toolbox! You won't have to limit your dating pool! Don't you want to be one of the cool kids who are PrEPping?

Don't be a dork, get that prescription! It's revolutionary!

[quote] Don't you want to be one of the cool kids who are PrEPping?

R88 would be a pro-lifer in THAT debate.

Never mind the fact that PreP does offer another "tool in the toolbox," if everyone isn't doing exactly the same thing every second of every minute of every hour of every day, Miss R88 might lose her shit! We can't have that.

We can't have grown, educated, well-informed people make a decision - yes, no or maybe some other time - for themselves. Oh no. Miss R88 disapproves. She doesn't trust your ability to make decisions, and thinks people are making major medical decisions on the basis of what looks "cool." Because, of course, the opinion of the majority rules HER life.

So stand next to R88 and HISSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS at PreP!!!!! Boo! Hiss!

[quote]If condoms were the be all end all then HIV would have been contained and pretty much a relic of the past here in 2015.

Oy, vey! Yeah, and it WOULD have been, but so many ignorant drug-addled drunken, meth'd out gay men refuse to use them! Condoms always work when USED correctly, but with a predictable population of mostly younger gay men who refuse o even know their status, who then DECIDE to bareback, we have the continued presence of HIV and AIDS in the gay community.

As someone who lived through the big die off, and lost a whole community of friends and neighbors, the Truvada population angers me, because they are in part the group playing Russian Roulette already. I suppose this will be good for them. I wonder when the facial wasting thing hits what will happen then. I'm happy to use a free condom, and stay HIV negative, but that's just me I see.

r89 your hissy fit comes out when you're worried the marketing message is getting sullied. Good. The fact is: Truvada offers no benefit over condom use. None. HIV infection is easy to contain. We've been doing a good job of it.

Grown, educated, well-informed people know the best way to prevent HIV infection is to know your status, discuss it with sex partners, and use condoms where appropriate. That's what works. Even you know it. But you'll trot out a line using passive voice and 'wouldn't it be over by now if condoms worked?'

Truvada's message of 'You Don't Have To Worry Anymore!' is just a huge step backwards that encourages people to be less in control of their own lives, and trust big pharma to take care of them instead. Yeah, that never ends poorly (thalidomide, phen-phen, the list goes on ...)

This will be hugely lucrative if otherwise healthy HIV- men get convinced to take a $13K drug they don't need just in case .

Bring on more insults, with your on-message marketing.

NYT 2012: "In one major study, only 10 percent of the participants took Truvada as directed."

This was when it was being discussed for Prep but before it was approved. The high-risk groups who would benefit most are least likely to use it properly.

The worried well is where the most money but least benefit (relative to risk) is, which is why we're getting the current messages.

The possible liver damage and facial wasting aren't worth it to me. I'm already at a lower risk and I've never had an STI so I'll stick to condoms.

HISSS!

The only way to avoid AIDS is to sit in a dark bedroom and never open your caftan!

HISSS!

This is sluttier than being pre lubed.

This is my guess, not based on evidence--One problem with the early studies is that they mainly focused on super high risk subjects already doing considerable damage to their bodies and lives w/ drugs, alcohol, high number of unsafe sexual partners. Very few of these people proved capable of adhering to the very easy once per day dosage (and remember, you actually only need to take it 4-5 times per week for the benefits)

But the main audience for this drug are those who are imperfect with condom use and/or would like to use condoms less often.

Part of HIV education has always been that you can't tell who's got it so you need to use condoms with absolutely everyone if you want to remain negative. Now for some of us, it'll be more like the calculus that straight people make when it comes to condom usage. And the more people that are on the drug, the less likely HIV will be spread to those who make the decision not to go on it.

Just as predicted, more hissy fits, right on cue, r94.

People don't want facial wasting or lipodystrophy or diarrhea r94. Don't answer the questions just keep on with your insults. That's how to win your market share. Hissing, caftans.

[quote]Part of HIV education has always been that you can't tell who's got it so you need to use condoms with absolutely everyone if you want to remain negative.

You can know your status and discuss it. There are plenty of HIV- guys having sex without condoms and the sex is perfectly safe. Truvada doesn't improve safety. It makes you depend on a drug company instead of yourself.

The people it stands to benefit most are people who are putting themselves at high risk repeatedly. It offers negligible benefit to the worried well who are already acting with caution. If you have sex with a lot of strangers and are often drug/alcohol impaired enough for it to affect your judgement, Truvada PrEP can help.

I will never understand the new euphoria happening over something that is 99% effective for preventing HIV when we've all along HAD something 99% effective for preventing HIV that also is inexpensive, prevents other STIs and has no known side effects.

Someone please explain this to me.

[quote] Please put your personal feelings aside for a moment and consider the following fact. About 30 years after the height of the aids crisis, only one in six sexually active gay men use condoms absolutely all the time. And while very effective, condoms still have a failure rate. Truvada is a tool some of us can use to remain negative. It's not for everyone.

So what makes you think they're going to be responsible and remember to take a pill every day? My personal feelings are I don't understand why people would want to potentially poison their bodies, exhaust their savings and use a drug that only prevents ONE thing when a condom does it all for pennies and no health risks.

The way I look at it, if you can't stick to safe sex then take the pill. Not everyone has a strong enough will to stick with something (which is exactly why America is so fat and lost of people smoke, drink to excess, and drugs).

We are all imperfect.

Take the pill so you don't get AIDS. Sure, big pharma is terrible and it's horrible that people may expose themselves to other STIs--it'e the chance everyone takes.

At least there's an option now to consider seriously. Be honest with yourself and what you have the willpower to do.

SO you have the willpower to use a condom every time? Do you have the willpower to take a pill every day and go to all the required check-ups?

Let me tell you this--every single person with HIV wishes he had taking this pill

[quote]Nevertheless, as my doctor anecdotally quipped, if a super strain was likely, it would have already shown itself. We are 30+ years into this epidemic, after all

Your doctor doesn't know what he's talking about. Consider TB. It has been around for hundreds of years - if not thousands. It is only very recently that a drug-resistant strain of TB has developed. Why did it only develop in the last several years? Because people who had TB took the drug until they figured they were better, then stopped taking it. The problem is that you have killed the majority of the TB virus so you feel fine, but a few - in fact the strongest, most resistant little buggers - are still alive.

Most people will take Truvada sensibly and consistently. Some won't. Some will miss a few days here and there. Those people will still have enough of the drug in their system to fight all but the strongest, most resistant little buggers. When that happens often enough, you will have a much more potent strain to deal with.

You get tested once every three months. So, when you test negative you go out and celebrate. But you've missed a few doses. You can contract HIV and everything else that will make a dick wilt, and pass it all along for the next couple of months until you go in to be tested again. You can't trust someone because he says he's on Truvada unless you were at his side every day watching him take it.

r101 I think the point is that the claims Gilead is making about public health benefits of Prep get eroded by the demographic facts/risks of the people those benefits are most dependent on.

Saying every single person with HIV wishes he'd taken this pill is really stooping low. I'm sure there are a lot of wishes/regrets every person with HIV has, but using this to push a pill is just beneath contempt. You should be ashamed of yourself for even saying that.

Let's not take cholesterol meds, antidepressants, blood pressure meds, and insulin. We should not try anything to prevent or halt progress of disease.

Inept comparison r104.

This is about taking expensive, powerful medications with side effects for something you don't have and is easily preventable. But the companies who charge $13K for them keep telling us we're helpless faggots who can't control ourselves so we better take this pill every day.

Nobody takes antidepressants and risks the side effects because they might get depressed. Same for all the other drugs you listed. Nice try.

Never did see an answer to R12's question on facial waisting. For me, I don't think this is an option. I think this is a false panacea. To many ifs, ands or what's. At this stage of the game, I am not ready to put a drug in my body that could cause some of the side effects seen in earlier treatment. I think PReP would be good for monogamous couples where one is positive and the other is negative.

I'll never understand why some people get on these threads just to shit all over them. It's just like gay marriage opponents: if you don't like gay marriage, don't marry a gay person. If you don't like the idea of taking Truvada, don't take it. It's that simple.

I can say that since I began taking it I'm actually having less sex. Taking such a big step as putting this drug in my body really made me think long and hard about what I was doing. I"m glad to have the protection but rather than being sluttier than before, I'm less slutty than before.

I have found that almost all the white guys I've been with this year are on it. A few of the latino guys are, but not many. None of the black guys I've talked to are on it.

It offers peace of mind. And to the person who's asking why use it when we have something already that's 99% effective, well the answer is, we don't. Condoms have never been 99% effective. They are about 85% effective. So Truvada is quite a bit safer than using a condom.

I had about 10 days of light nausea when I started it, then nothing. My drug company actually covers the co=pay, so I get it for free.

Condoms won't damage your liver or eat your face up in a few years though.

I'm starting to wonder about the shill thing because I'm finding it odd how some of the pro Truvada posters randomly mention the racial/ ethnic demographic groups who use the product. It's just out of the blue as if to suggest that all white gay men should take it because it's the in thing among white gay males ( and white gay males just so happen to be the majority of this forum). It seems like an odd form of peer pressure or something.

I mentioned it because someone upthread mentioned it. I had never thought about it before, but then when I saw it mentioned I realized that almost every white guy I have been with in the last six months admitted he was on it. I'm kind of stunned by that myself, but I live in LA and a lot of guys are on it.

Wouldn't it have the greatest public health benefit if it was made available to marginalised, high-risk MSM, instead of the educated, affluent, white folks who already face a lower risk anyway? Of course, it wouldn't be as profitable then. I've kept myself negative for decades without having to take heavy duty drugs to do so, so I see no need to start taking it myself. I wish people would be more honest about the fact they just want to take it to bareback, instead of mealy-mouthed euphemisms about 'peace of mind'.

R97 honestly thinks Truvada is about marketing.

I cannot reason with someone who does not have the capacity to reason.

From what I understand, NY worked with insurance companies to make sure truvada was covered. So, if you're insured, no matter what ethnicity you are, you can get it.

Whites may just tend to trust using a daily medicine more than blacks, which is why people don't see blacks using it so much yet.

Look, I used to be one of the naysayers originally, but I also know tons of men who died of AIDS.

Everyone chanted, WE WANT A CURE!!

Well fuck, here it is and people are complaining its imperfect. Just silly

If the Virgin Mary took Truvada, she could claim immaculate creampies.

As an HIV+ top male in my late 30's who seroconverted 2 years ago, I recommend to all my friends that are thinking of going on such a drug regime to talk with their (preferably gay) doctor.

There is a misconception that being a top makes you less at-risk for HIV transmission in this thread. This is simply not true. How do you think straight men get HIV?

Also I don't have any side effects yet. Facial wasting and lipodystrophy are side effects of a previous generation of drugs. My kidney's are fine. I worry that my health may one day change and I visit my doctor quarterly, but I also worry about getting killed in a car accident or hit by a bus. Both fates that have a higher probability to cause my demise than being HIV+ today.

Yes, given the chance I would have liked to have the option to take Truvada, but it didn't work out that way. If your insurance will pay or you can afford the price of the medication I strongly suggest you go on it.

[quote]There is a misconception that being a top makes you less at-risk for HIV transmission

That is not a misconception. Topping is less risky than bottoming. But it's still risky.

I'm thinking about go on it myself (top here). What about the facial wasting?

[quote]I cannot reason with someone who does not have the capacity to reason.

See that right there shows your true motives. A disinterested person would respond to any questions with rational responses. The fact that all you can do is sling insults (and STILL not answer questions about facial wasting) suggests there's an ulterior motive. Anyone with questions is insulted and dismissed. Do your hissy thing again.

R116, how did you seroconvert? Just curious. Was it one time without protection, trusting someone who wasn't trustworthy, an accident?

As posted in R116, facial wasting is a side effect of a previous generation of drugs. No longer as prevalent as before, but everyone has different reactions to pharmaceuticals. R120, doesn't really matter, but was an accident, a one time lapse in judgement with a hook-up. Things happen in the heat of the moment when you're thinking with your cock instead of your brain.

In my observation, the loudest Truvada cheerleaders are all already HIV+ guys. I mean, do they have a horse in this race, or is it that they want to have the opportunity to not bring up their poz status if they know their partners are on PrEP?

Never understood seroconversion and after reading this still don't. Science/Biology was never my best subject..

In immunology, seroconversion is when a specific antibody becomes detectable in the blood, and the corresponding antigen becomes undetectable. During an infection or immunization antigens enter the blood, and the immune system begins to produce antibodies in response. Seroconversion is the point in time when the amount of antibody in the blood exceeds the amount of antigen, and the antibody becomes detectable. Before seroconversion, the antigen is detectable, but the antibody is not.

R122, you may have a point in not wanting to bring up their HIV status, but I also think they realize that if they had the opportunity to go on Truvada they would most likely not be HIV positive. Say what you will about the bitchy awful queens on DL, there is something to be said for looking out for your own and that's the reason I think HIV positive guys may be the loudest cheerleaders for Truvada.

Yeah but why would the person praising Truvada say misleading and untrue things about insertive partners and their risk level? It's well known that the insertive partner is at a lower risk for HIV transmission so it's odd that someone who is praising Truvada would say that this is a misconception and imply that tops need to take it too.

R125, maybe because I'm a top who is now HIV+?!

By your logic no tops or any straight men would ever get HIV. While it may be lower risk, it all depends on too many factors to give credence to tops being exempt from taking Truvada because they have a slightly lower risk level.

R123 Think of antibody and antigens as a lock and key mechanisms (where the key must match the lock in order for them to work). Let say the antigen (in this case the protein used to detect HIV) is the lock. Your body's immune systems detects this antigens (its a complex procedure I wont go into) and starts producing antibodies (in our analogy the key) in response. Remember antibodies bind to antigens in order to mark the thing detected as "foreign" so the your body's immune system can identify it as something that it must destroy. So when the body starts producing the keys (antibodies) they start going into their corresponding locks (antigens). During the initial key production, since there are more locks than keys, all the key are used up immediately, making it hard to detect via blood test etc. But eventually more keys than locks are available (because the available locks have keys in them and the body doesn't stop producing antibodies as soon as all the antigens are blocked with antibodies) and the amount of keys becomes detectable (seroconversion). Remember that chemical analysis have a concentration threshold, this means that below some concentration chemicals are not detectable even if they are there in very small amounts. I hope this helps.

If you don't understand that lower risk ( and it's not just slightly lower the studies are out there) doesn't mean no risk or never happens then refrain from using the word logic. Anyway you've pretty much answered my question, it's clear that you have ulterior motives which discredits everything you've said.

My big question for OP and others like him: We're told to NOT believe guys who say they are negative. But we are supposed to believe that when guys say they're 'on prep' that they have been taking it as they should with no skipped doses? What about the guy who just started on it today? How long does it take before you can make the claim that you won't get infected?

No pill is foolproof. Nothing is 100%. Some guys on prep will become HIV+. Maybe it's 1% maybe it's half of 1%. maybe it's 5%. Anyhow the 95% success they claim is not 100, but people here are behaving as though it is.

The anecdotes here prove what i suspect: this is just encouraging people to take more risks.

[quote] Everyone chanted, WE WANT A CURE!! Well fuck, here it is and people are complaining its imperfect. Just silly.

Ummm, Truvada is NOT a cure. it's not going to all of a sudden convert a positive person back to negative. Are you kidding?

It's a preventative measure, the same way a condom is, only a condom prevents more. The only thing Truvada does that a condom doesn't is allow one to bareback, and it doesn't even really do that, though that's what a huge percentage of gay men are taking it to mean.

I saw someone's profile yesterday on a hook up app who stated, "Proudly on PrEP," and I thought, why is that a source of pride?

I'm not interested in being a guinea pig for big pharma.

I'd like to see what shape you guys are going to in, in say, 20 years after taking all this shit.

Truvada AND then you've got the anti-depressants, AND the pills to get to sleep, AND the pills for cholesterol, AND the pills for acid-reflex, ...and on and on.

No thanks.

R130 "Proudly on PrEP" WTF that is the most moronic thing I have ever read regarding this topic. What a brainwash.

[quote] [R130] "Proudly on PrEP" WTF that is the most moronic thing I have ever read regarding this topic. What a brainwash.

I know!! I was very tempted to ask him about it, but I didn't think he'd engage me on such a topic when he was likely looking to just get barebacked.

So much shaming. So what if people are fucking SICK of condoms and don't want to use them? Now they don't have to. Why does it get your panties in a twist? If you want to use condoms, then use them. Why is it any of your business what somebody else does?

What 'shaming' r134?

Because people don't want to trust drug companies and have made the point repeatedly that this drug doesn't offer much, in terms of protection, that we don't already have at our disposal? I don't call that shaming, I call it rational.

If you want to be a guinea pig for big pharma, that's your choice. No shame in that!

Thanks for proving my point, asswipe.

[R129] If you're on PreP, you don't have to take anyone's word for it when they say they're on it, because you are the one protecting yourself with the pill. If someone tells you that you don't need to use a condom because THEY'RE on PreP, you might as well be taking their word that they're negative.

[R110] I was the one who started the discussion about ethnicities because I know people in the USC and UCLA studies and spoke w/ a doctor involved with the third Los Angeles study.... It's odd you think the mention of white people taking it is somehow related to pressuring other white people to take it. But that's primarily who's taking it right now.

Guys say they're proudly on PreP because they're willing to put themselves out there and risk people assuming the worst or sluttiest about their sexual behavior in order to educate and inform other gay guys who may be at risk of contracting HIV.

I love the way people pop all kinds of chemicals (no one knows what mixing all of these pills together does to the body), yet worry about pesticides on their vegetables and hormones in their meat.

They blithely take all of this shit but complain about Monsanto and GMOs.

Nuts.

Your choice, no shame, r136. If the people making points here expressing skepticism make you feel ashamed, maybe you need to work on that. Calling people 'asswipe' just makes you appear more ashamed and immature.

R130 while PrEP is not a cure, it's analogous to a vaccine.

If there were an effective vaccine against AIDS, would you get it?

Guess what, Truvada is here.

It is NOT a vaccine. It is nothing like a vaccine. That is a really irresponsible thing to say. A vaccine you get ONCE and you get immunity.

You have to take this pill everyday, forever, or as long as you want protection, and it does not guarantee immunity. It inhibits the virus' ability to replicate. Same mechanism if you already had HIV. You are basically taking the same medication that someone with HIV would take, but you take it in order to prevent infection instead of to treat it.

R141 basically it works like a vaccine. It prevents infection if you take it.

There are many vaccines one has to take more than once. Some need boosters; some have two or three-shot sequences.

This one you take daily. While not a vaccine by definition, the outcomes are the same.

I love sex. I'm a horndog--I completely admit it. I refuse to be slut-shamed. It's my life.

I take Truvada happily.

Fuck you if you judge me. Who cares what you think of my life? I bet I'm having more fun.

No it is not, r142. You are either woefully misinformed or you are a shill trying to deliberately mislead people.

A vaccine triggers an immune response that makes your body create antibodies to a given virus so that if you encounter it in the future your body knows not to react. Since viruses mutate boosters are needed sometimes.

Truvada is an antiviral drug. It has nothing to do with a vaccine. Its outcome is nothing like a vaccine. Nobody takes this drug and gets HIV antibodies that make them immune to HIV. This is a drug that targets viruses and it works only for as long as you take it. There is no immune response. Its sole purpose is to cripple the HIV virus if it encounters it. This is not a vaccine, it is an antiviral drug.

Stop misleading people. It is beneath contempt.

[quote] Guys say they're proudly on PreP because they're willing to put themselves out there and risk people assuming the worst or sluttiest about their sexual behavior in order to educate and inform other gay guys who may be at risk of contracting HIV.

Oh, is that what they're doing? So they've gone from barebackers to crusaders. My hat's off to them.

These responses are very illuminating. People really need to do some more research before blindly popping a pill.

R145 I want my bareback and I want IT NOW.

[quote]If someone tells you that you don't need to use a condom because THEY'RE on PreP, you might as well be taking their word that they're negative.

See this is what I don't get. Guys are believable when they say they're on prep, but not otherwise? People here are always saying 'assume everyone is positive'. Even if they say they are negative. So now we are to throw that out the window too, as long as the guy says he's on prep? This certainly is a wonder drug isn't it?

French scientist Francoise Barre-Sinoussi, co-discoverer of HIV, at this week's International AIDS Society Conference:

"I am not sure, by the way, we will have a cure. I used to say to develop a cure for HIV is an impossible mission."

"We are starting again to see the epidemic starting in the gay population -- at least in a proportion of the gay population in Europe, Australia and United States. I am a little bit worried that we'll start to have the same profile of the epidemic that we were having in the early 80s."

"There is a proportion of treatment, after many years, that develop complications, and there are co-morbidities. The general population is not very well informed about co-morbidities. I saw when I gave a talk to the public, when I start to think about cancer, or aging diseases that appear in patients on long-term ARVs, they say "nobody told us." They are not fully informed and we have a responsibility."

Link for Barre-Sinoussi's interview:

I was genuinely interested in the subject until posters started appearing to act like shills and adapting their messages to specific posts and the forum as a whole. I'm an exclusive top, I don't use drugs( or drink), I've never had an STI, I use condoms ( because I'm very paranoid about contracting STIs), and these things make me a lower risk for HIV. I was considering Truvada for extra protection in case something unexpectantly goes wrong. However, when I realized that I'd be taking a drug for something I don't have that could damage my liver and cause facial wasting among other things I realized that it wasn't worth it because I've already been doing a good job of keeping myself STI free. So some of us were interested in this topic until it became obvious that some of the posters obviously have an agenda.

R150 I like you. You seem like a responsible guy with yourself and others. Keep it up :D.

It's feeling to me like the same people who won't wear condoms or get themselves in a position where they're reckless now and then (for whatever reason) and bareback are the ones who are trumpeting the use of Truvada the loudest. This does not strengthen my faith in either the drug or the people who take it. Again, simple logic dictates two things which this issue really boils down to...

1- Taking Truvada only helps prevent HIV transmission, no other STIs, so you still need to wear a condom.

2- If you're wearing a condom, then you don't need to take Truvada.

Once again, if you don't like it, don't take it. It's really that simple. No need to come and shit on those who do take it. It's a choice.

Nobody's shitting on anyone r153. Just a lot of good questions.

I'm still curious why we shouldn't believe guys who say they are negative. Unless they are on truvada, in which case people here say we should believe them.

Am I 'shitting on' Truvada-takers by asking that question r153?

[quote] Once again, if you don't like it, don't take it. It's really that simple. No need to come and shit on those who do take it. It's a choice.

I'm not shitting on anything. I'm asking legitimate, logical questions on the reasons one would take Truvada over using condoms, and the answers I'm getting are evasive, at best. This is an important issue for the community and my sense of it all is that people are ignoring a lot of facts and blindly going on the medication, it seems to me, in order to bareback. And I think that's dangerous and irresponsible, and if you don't like it, then maybe you should really sit back and examine why you're taking it.

"The same people who won't wear condoms or get themselves in a position where they're reckless" - You're referring to the 84% of the gay male population. Only 1 in 6 say they use condoms every time over a (either 2 or 5) year period. It's great that you enjoy condom usage AND that you put risk of other STI's on same risk scale as HIV. You don't belong on this drug. Good for you! You're not everyone or even the majority of HIV- men.

Another fun fact: In an early study, some of the men taking Truvada who said they use condoms "every single time" ended up with HIV. Were they liars? Did they get really unlucky with condom usage? All we do know is that their blood tests suggested they were taking it once or twice per week, not every day.

[quote]it seems to me

key phrase that. I talk to my Doctor and to qualified (very, very qualified) people that have been working in this field for decades. They say it is safe and effective.

All you have to offer are some feelings of mistrust for fiendish dug companies who are obviously worse than HITLER and all the evil doctors that are CLEARLY in their thrall for profit.

Do what you will. Believe what you will. But you should know that your beliefs are not based in any reality or science. I'll listen to my doctor. I'll listen to the community of professionals that actually know what they are talking about and have the science to back it up.

I have been on the drug for a month now. Everyone on this thread keeps screaming at the top of their lungs that it doesn't prevent you from catching other STI's, and they are completely right. BUT, are you using condoms for oral sex as well?? Didn't think so. A woman at the clinic where I get tested regularly said she has been asking that question for a decade, and only ONE man say he used condoms for oral sex. So yes, you can get gonorrhea, syphilis, chlamydia, and herpes from unprotected anal sex. But you can also get the SAME 4 from unprotected ORAL. Which every single gay man engages in.

[quote]Another fun fact: In an early study, some of the men taking Truvada who said they use condoms "every single time" ended up with HIV. Were they liars? Did they get really unlucky with condom usage? All we do know is that their blood tests suggested they were taking it once or twice per week, not every day.

So Truvada did not work for this guy, who, based on blood tests, was taking it incorrectly. Is his HIV now truvada-resistant? Now if he spreads his HIV to someone who's been on PreP correctly, will the recipient's Truvada also not be protecting him in the way he assumes?

This is exactly the scenario that people were worried about early on, and has been mentioned in this thread. The people who stand to benefit most -- those who put themselves at risk and will continue to do so -- seem to be the worst at adhering to a regimen, and could be creating stronger strains of HIV that might resist treatment.

I guess the 'he' was a 'they' in the example or guys becoming HIV+ on Truvada. Which makes it even scarier.

[quote] "The same people who won't wear condoms or get themselves in a position where they're reckless" - You're referring to the 84% of the gay male population. Only 1 in 6 say they use condoms every time over a (either 2 or 5) year period. It's great that you enjoy condom usage AND that you put risk of other STI's on same risk scale as HIV. You don't belong on this drug. Good for you! You're not everyone or even the majority of HIV- men.

And therein lies the problem, and a fucking pill isn't going to solve it, especially one where you have to be ruthlessly diligent in taking it every day. If 84% of the gay male population is reckless when using condoms, then how are they all of a sudden going to transform into reliable, trustworthy gents who take a pill when they should? But gay men are looking at this as a completely infallible solution to a problem they wouldn't even have if they used condoms.

The problem isn't the method of of preventing HIV, it's the drug companies telling you all these diseases are manageable, so who cares if you get it, just take our pill and you'll be fine. That, over the past 20 years, has completely eroded the seriousness of HIV and why it's on the rise again. No, it isn't a death sentence, and the drugs that were developed were a godsend for so many people, but this is a 100% preventable disease without having to abstain from any kind of sex, as long as you take precautions. But most gay men won't take precautions because they simply do not know, understand or remember how bad having HIV ultimately can be. What they should be teaching is all the things your body goes through after you seroconvert and how, even though you'll live longer than you would 30 years ago, you're still going to die a premature death. In first world countries, we should be talking about HIV the way we talk about bubonic plague.

[quote]I'll listen to the community of professionals that actually know what they are talking about and have the science to back it up.

Does that include Francoise Barre-Sinoussi, at r148?

[quote]They say it is safe and effective.

Current HIV treatment is said to be safe and effective as well. But as the scientist in the link at R148 explains, the medical community has not done a good job of explaining the long-term effects and co-morbidities of the treatment. It was only a few years ago that it was discovered how dramatically HIV treatment accelerates the effects of aging in some people. The same may very well be true of Truvada.

[quote] Do what you will. Believe what you will. But you should know that your beliefs are not based in any reality or science. I'll listen to my doctor. I'll listen to the community of professionals that actually know what they are talking about and have the science to back it up.

No, what I'm actually going to base it on is not some doctor who's not out there among gay men having sex and only has drug company rhetoric to fall back on, but the gay men I encounter on hook up apps who advertise themselves as being on Truvada and then want you to fuck them bareback. So, yes, IT SEEMS TO ME, because I have the experience to make that observation. Get back to me when your doctor has gotten out there and attempted to sleep with a bunch of bottoms on Truvada.

[quote]Current HIV treatment is said to be safe and effective as well.

So nobody gets HIV anymore? Really?

Current (barrier) HIV prevention is better than nothing but it is certainly not safe and effective as evidenced by continued infection.

And r64 - you need to think a little bit about why you despise the "bottoms" that you apparently like to fuck.

Treatment and prevention are two different things, R165.

This thread is about prevention.

[quote]So much shaming. So what if people are fucking SICK of condoms and don't want to use them?

You are a sex-negative condom shamer!

Typical that you shame the very population doing the most to save gay lives. You sound like a real down and outer. Do you support people who are tired of drinking and not driving? Drunk drivers seem like your crowd!

Could a knowledgeable non-biased person answer the question about truvada resistance?

If guys take it but skip enough doses that they become HIV+, do they become carriers of truvada-resistant HIV? And does that mean other guys who are on truvada would not be protected from those strains?

Seems like that is happening, and it kind of defeats the whole purpose.

I don't want to get poo or anal mucous in my urethra. So, I only fuck with a condom...don't care if the bottom is on prep or not. I never had the joy of fucking BB... Durex sensitives are just fine. But I guess if you don't like it, take the pill. I don't know why people care so much about what others do. This issue is so controversial, it's crazy. If infections continue as they were - then that's that. If they decline - ok great. If they increase, I'd be surprised - but they might have increased anyway.

Is bareback sex THAT great? Honestly. Maybe I'm just a germaphone but I don't want to fuck an ass hole bb.

The only problem is that there's only 1 drug left to treat many cases of gonorrhea, but most of that is transmitted orally anyway. Ceftriaxone is still working well - but who knows in 20 years.

R169, from what I read in the iprex details, the HIV strain was not truvada resistant. This was a long time ago and it's buried in the study text... and seems theoretically the opposite of what should happen... but I think that's what they said. Even if you have NRTI resistance, there's still a lot of other drugs now anyway, though the PIs are harder on your system.

It probably will happen eventually, R169. But, the development of a superbug usually takes more than one generation.

Considering the transmission of HIV hasn't actually decreased in years, perhaps we should actually encourage people to use something that does.

Sure condoms work but people don't want to use them. Just stating a fact.

We have never cured a virus. NEVER.

We can only prevent infection-- by avoiding the virus, by vaccine, and now with an anti-viral.

For HIV we have two choices now. Sure there may be side effects but a side effect of not taking precautions is getting HIV

[quote]We have never cured a virus. NEVER.

Hep C has a cure.

[quote]But, the development of a superbug usually takes more than one generation.

Generation in human terms or in drug terms? We already have treatment resistant staph, and other bacteria. It's an arms race with antibiotics. I hope the same doesn't happen with antivirals. But I guess there's no reason it wouldn't.

[quote] Considering the transmission of HIV hasn't actually decreased in years, perhaps we should actually encourage people to use something that does. Sure condoms work but people don't want to use them. Just stating a fact.

Yes, exactly. But you're stating the very reason why Truvada won't work in the long run. The problem with condoms isn't condoms, it's the men who are too lazy or irresponsible to use them. So unless Truvada has a built in side effect that, besides preventing HIV, also suddenly makes men super responsible, you have the same issue you currently have with condoms.

There has been absolutely no talk from anyone in the medical field about a Truvada-resistant strain of HIV.

As the poster above mentioned, unless you use condoms for oral sex, screaming about needing condoms for anal sex because of other STIs is just stupid. If you suck a guy's cock and but then insist he use a condom to fuck you, in what world are you not going to get his syphilis/herpes/gonorrhea/ etc anyway?

Wow r177 you certainly have not been paying attention. Gilead should fire you. "There has been absolutely no talk from anyone in the medical field about a Truvada-resistant strain of HIV?" Really?

See story at link from January 2015: While Rare, Drug Resistance After Contracting HIV on PrEP Can Occur

And another. See comments: "There are already strains resistant to one of the two drugs in Truvada."

r177 is an idiot, or a liar.

R169 Eh too much info too write down, ask a health professional about it or even better an immunologist (doctors are parrots, the immunologist actually at the forefront of this).

Prevention, in the long term, is a cure. You fucking sex negative Mary's just can't deal with it.

Sure r181 but your brand of prevention depends on everyone using this pill correctly, and it's clear that's not happening. This prevention effort is only as good as the people on the front lines of it.

The lack of real answers, especially r180s dismissive 'too much info, ask an immunologist' is pretty telling. Larry Kramer's 'rocks in their head' remark is making sense to me now.

You should make that into a bumper sticker R181, make it easier to identify you "radical" thinkers...

[quote]your brand of prevention depends on everyone using this pill correctly

and yours depends on everyone using condoms correctly - which they do not.

In fact: my brand of prevention only requires that I take the pill correctly - which I do. The status of my partner is irrelevant as HIV is not going to be transmitted.

Time will tell. Dosage will be adjusted. Long life delivery systems will be developed. Costs will come down.

Most importantly - infections will be prevented. That's the point, isn't it?

[quote] and yours depends on everyone using condoms correctly - which they do not. n fact: my brand of prevention only requires that I take the pill correctly - which I do. The status of my partner is irrelevant as HIV is not going to be transmitted.

But why would you not use a condom? You say you'll use the pill correctly, okay. Then I will assume if you are responsible enough to do that, you're responsible enough to have a tiny, easy to carry condom on you and use that. So I would really like to hear why you feel being on a harsh medication that hasn't been proven completely side effect free would be better for you than using a condom, which essentially does all that the pill does and more.

And here I thought condoms were idiot proof... how can you not use one correctly? O.o The only forgivable thing is using oil based lubricants and not by much!

[quote]In fact: my brand of prevention only requires that I take the pill correctly - which I do. The status of my partner is irrelevant as HIV is not going to be transmitted.

That is where you are wrong. If OTHER people take Truvada incorrectly, they could be creating a truvada-resistant strain of HIV. Your correct behavior won't matter, because the new strain has outsmarted the drug that you are depending on.

This was the concern from the outset of approving antivirals for preventive use, and it seems to be coming true.

R28 is a company shill.

Truvada is meant to be used in conjunction with condoms, NOT in place of them. It's for slip-ups. It is not 100 percent, not even in rare slip up situations. The last study done showed that , of gay men who took the drug, only 12 percent took it every day like they were supposed to. It's not effective if it's not taken every day. The overall effectiveness rate is not clear. In studies, Truvada was only 42 percent more effective at stopping HIV transmission than placebos. But not all the people were taking their pills everyday, so it's hard to say. When they tested the blood of people who had the pill in their system, those folks were 72 percent less likely to contract HIV. Here's where it gets interesting. So they then extrapolated it to the general population, with the variable being that the folks took it every day as prescribed (along with other variables involving the participants having safe sex education, etc), and suddenly the number jumped to 92-95 percent. But that's not actual numbers from testing, it's only statistical probability. The real number is 72 percent, but the magic of manipulating stats allowed the company to claim the higher number.

You're insane if you use this in place of condoms. You're safer than doing nothing, but you're not SAFE. Condoms, if used correctly, are much more effective.

[quote]But that's not actual numbers from testing, it's only statistical probability. The real number is 72 percent, but the magic of manipulating stats allowed the company to claim the higher number.

OK that is a shocker. I thought the 95% was based on actual science, not estimating. Can you back that up r188? Where did you get this info?

Now that I think of it, if people can't manage to handle correctly something as simple as a condom, how can they manage a pill with a strict regimen and some shaky foundations? Very worrisome.

[quote]Condoms, if used correctly, are much more effective.

You post it and post it and post it but you know what? People are not going to behave the way you want them to - no amount of screaming will change that one little bit.

Real people are making what they believe are informed choices by "status" and "position" sorting "hey you're neg - right? Ok then we're fine." or "I am an exclusive top so..." That is not prevention - that is rationalization. Its what people do. Public heal needs to deal with how people actually behave.

Condoms are a temporary solution to the problem - a poor compromise between desire, behavior, fear and a nasty virus. Compliance has never been anywhere close to 100% as demonstrated by the fact that people are still getting infected. Public health makes a priority of preventing infections - not screaming at people because they do not behave the way you would like them to. We needed something better. PReP is what we have.

Anyhow - the arm-chair epidemiologists of DL have shouted this discussion into oblivion. They obviously know better than CDC, Fenway and all the others who have spent their lives doing real science and real work in HIV prevention and treatment. All of them are obviously wrong in supporting PReP because you *feel* they are because... well... they just must be because.... EVIL PHARMA or IRRESPONSIBLE BOTTOMS or Whatever. SEE - look at this article that actually says the opposite of what I say it says!!!

Out.

What is your point r191? Maybe if you addressed some of the valid questions that have been raised here, instead of being dramatic, you could convince people.

Public health IS about preventing infections, and that is why public health experts expressed doubts when Gilead first asked the FDA for approval to sell their antivirals as a prevention tool.

If we heed your advice that 'people are not going to behave the way you want them to' that also means the same people will undermine the efficacy of Truvada.

Hey asshole r179, did you even read the article you posted?

Myth: PrEP will create a drug-resistant HIV.

Truth: The iPrEx study, a large international research project on the use of Truvada for PrEP, found a low risk of drug resistance — in fact, the only cases of resistance developing were in people who had unrecognized acute HIV infection. This drives home the importance of being tested for HIV regularly while on PrEP. While it is also important to take your PrEP medication every day as directed, study participants who missed doses, resulting in what study authors called "periods of low drug exposure," did not have a greater risk of developing drug resistance. Drug resistance is a concern for people with HIV, but not one associated with PrEP. A recent study found that 16 percent of HIV strains in newly infected people in the U.S. metropolitan areas are resistant to one or more HIV drugs. Resistance generally develops when people with HIV don't take their drugs regularly, therefore allowing the virus to multiply and mutate into a drug-resistant strain. Truvada is used to treat HIV as well as prevent it, so you don't want to develop resistance to it — but the key, if you're taking it for PrEP, is to get your regular HIV tests to make sure you're remaining negative.

Hey asshole r193, the question is: once someone who is HIV+ develops a resistant strain, are the people who are on prep then vulnerable?

And read that last sentence of the quote you posted, asshole.

I can say asshole just as many times as you can, prick-for-brains. READ THE FUCKING PARAGRAPH. It gives absolutely no indication that a DRUG RESISTANT STRAIN OF HIV is developing. Or is reading not your thing?

R193 - I believe the same study also showed there wasn't a significant drop in condom usage amongst the population taking PrEP.

R192 - Where are you getting your information? The CDC and the World Health Organization both support PrEP. New York and San Francisco public health officials have done the same.

R194 - you want to know if a strain of HIV develops that is immune to current therapy would someone taking PrEP be at risk for exposure - sure they would be. Just like if a strain of HIV develops that can make its way through a condom then condom users would be a risk for exposure. Or if a strain of HIV developed that is airborne than anyone who breathes would be at risk for exposure. But like my grandmother use to say if wishes were horses than beggars would ride... The science doesn't support your fear.

I don't like the idea of possibly getting shit on or in my dick anyway so I'll stick with condoms on the very rare occasions I have anal sex.

[quote][R192] - Where are you getting your information? The CDC and the World Health Organization both support PrEP. New York and San Francisco public health officials have done the same.

Read the anecdotes above about the guys who didn't have much drug in their blood but claimed to be on prep. Do some googling, that has been the concern from the get go.

People here say you can't change behavior, etc with regards to condom use. The same applies to a daily pill regimen. With condoms, if you slip up, you only affect yourself. With Truvada prep, anyone's slip-up can affect everyone who's on prep by making it less effective. How are you going to know whether the guy you're having sex with is one of the guys described above, who claimed to be on prep but wasn't taking it every day , and seroconverted, and might have a treatment resistant strain thanks to HIS negligence?

Your comparison to a strain of virus that makes its way through a condom is just plain idiotic. You seem to be playing a game of tack a negative association onto every valid question aka shoot the messenger. Aren't you the person who said 'There has been absolutely no talk from anyone in the medical field about a Truvada-resistant strain of HIV?'

Completely wrong.

[quote]The science doesn't support your fear.

Also completely wrong. You admit that treatment resistant HIV is a threat but then go on to ridicule the idea by association.

People who take this drug incorrectly and also increase their risk (because they incorrectly think the drug is protecting them) are a public health disaster waiting to happen. You know it and anyone with any public health know it.

R198 - you've posted nothing to support the claim public health officials don't support the use of PrEP.

It's clear there is no point in talking to you about this. I'm not sure what your issue really is with PrEP - but as been pointed out over and over the science doesn't justify your fear. For example you don't seem to understand what a drug resistant strain of HIV is. You aren't willing to acknowledge the public health benefits - as supported by public health officials. Officials who quite frankly will not benefit directly or indirectly from the sales of Truvada. You certainly seem to have no understanding of making people making decisions based upon their assessment of their own risks and benefits.

No one is going to make you take Truvada or make you have unprotected sex with someone who says they are on Truvada. The public health benefit has been established. You don't have to do it and it's good for the population as a whole. What's the problem?

[quote][R198] - you've posted nothing to support the claim public health officials don't support the use of PrEP.

That's because I never made that claim. You continue to create false arguments to cover over any of the legit questions asked here.

[quote]The status of my partner is irrelevant as HIV is not going to be transmitted.

Actually, HIV will be transmitted, but (one hopes) will not take hold if you are using Truvada consistently. The only way to prevent transmittal of the HIV virus is with a barrier such as a condom.

[quote] No one is going to make you take Truvada or make you have unprotected sex with someone who says they are on Truvada. The public health benefit has been established. You don't have to do it and it's good for the population as a whole. What's the problem?

Well, A- it hasn't been proven it's good for the population as a whole, as evidenced by all the questions that are repeatedly being brought up here that all the PrEP cheerleaders either blithely ignore or shout down.

B- Sorry if some of us aren't only concerned for ourselves, but for others in the community. Yes, I will continue to use condoms, but I can still be concerned that people aren't really taking a step back and looking at the more likely reason gay men are using Truvada, a way that even the makers of Truvada are saying it should not be used.

C- All the PreEP cheerleaders are totally ignoring the one question that keeps getting asked. Why, if someone is not responsible enough to use a condom, will they all of a sudden be trusted to remember to take a pill every day without fail? Or make sure they get their prescription renewed so that they are never without the drug for one day? I will repeat- the problem is not with condoms, it's with behavior. And behavior does not all of a sudden change simply because you swap out one method of protection for another.

But please continue to shout anyone down who dares question your wonder drug. Continue to call them names and hurl accusations and belittle them.

R202 Thank you, its nice to see someone who understands this. Truvada is a mix of two ANTIRETROVIRAL drugs. These drugs prevent the REPLICATION of the HIV virus, it does not kill the existing ones. These means that if during sexual intercourse, 10 HIV viruses enter your body, Truvada will keep stop them from replicating, keeping your viral load low, but it WONT KILL THEM. So the 10 HIV viruses will still be floating around your system looking for the opportunity to replicate. So you when you say the virus wont be transmitted you are very very wrong. And this is a very important difference. This is why not missing a dose is so vital. If you do, you give the virus a chance to replicate. Then those 10 viruses become 20 and if you miss one again, they might become 40, etc. Then you have sex again and 5 more enter your system bringing your total to 45. Viruses tend to live a very long time they just wont go away easily. See how things can get complicated? The virus uses the white blood cells that are supposed to kill it as a host, but that is all news, but so important still.

R204, so, it's like herbal essence where they tell two friends and they tell two friends and so on and so on?

Thank you, [204] for posting that. It' excellent information to be aware of and it was completely new to me.

There is so much misinformation out there (and on this board) about the drug.

I'd like more information on R204 's comments about the virus continuing to live in the body. My understanding is that the virus is transmitted but can't replicate and dies out. 204 makes it seem like Truvada users are infected at a very low level (that can't be transmitted to others) and that the virus can eventually continue replicating after usage has stopped.

R173 while Hep C functionally has a cure, they sort of changed the definition of cure to call it that.

r204 could you provide more information? If you are on Truvada and contract HIV, can you then pass it on to others even if the virus can't replicate in your own body?

How long does the virus last in your body if you're on Truvada? Do you then test HIV+ even though the virus can't replicate?

R203 - Like I have said you aren't capable of rational discussion. If you don't want to be part of the solution at least try not to Pe part of the problem. We've been educating people about safe sex for over 20 years and yet infection rates have plateaued. But that doesn't seem to bother you. Again - I don't know what your problem with PrEP is.

Is having someone shoot a load in your ass this important to people?

R211 - No.

Could the person(s) here who keep saying the 'science' proves what a huge leap forward is PLEASE comment on the link below?

It's the account of a guy who went on truvada as prep and ended up getting HIV anyway. He says:

"My gene testing results are in. It now makes sense why Truvada failed despite 100% adherence. The virus that I have is resistant to emtricitabine, one of Truvada's ingredients. I am not resistant to Tenofovir, the other ingredient, which my doctor thinks is why my viral load is so low (1000) even after an estimated 3 months of infection. ... If you know anyone taking Truvada, please let them know not to rely on it exclusively. There are mutations of the virus out there resistant to the two drugs in Truvada."

This is freaking scary and is not being addressed here. The idea of resistance was dismissed. This post was from April 2015 so it's pretty recent.

" I was religiously adherent--I only missed a few doses when I was first taking Truvada. I did put myself at risk though on an occasion and I know that while very effective, Truvada isn't failsafe." Poor guy at R213's link. Missing a few doses is all you need to fuck it up. Gonna have to write an essay on this because its worrying!

[quote]I take the pill every day although it is pretty forgiving of occasional skipped doses. I have had zero side effects.

Well r38 you should read post at r213, it wasn't 'pretty forgiving' for this guy.

My doctor said if you wanted to stop Truvada you just have to take it for 30 days after the last time you had sex ( meaning sex in which you might have been exposed to HIV), after which you could stop. He would not have said that if the virus continued to live on in your body. If that were the case, you could NEVER stop taking Truvada. Once on it, you'd be on it for life, which is absurd. No one has ever said that was necessary.

The guy at link at r213 took it as directed and it didn't work, and it turned out the reason why was because he was infected by a strain that was resistant to one of the components of truvada.

I wish the truvada cheerleaders would address this. Nobody is talking about it and they should be. Prep only works if you never get exposed to a virus that is resistant, and there is no way to tell.

Webmaster should ask someone from Gilead to answer these questions. Lives are at stake.

R217 - I read most of the link at R213 - including those comments that were suspicious about his story. Where is the evidence he became infected because he was exposed to a Truvada resistant strain of HIV? The fact he claims his virus is resistant to one of the medications in Truvada has nothing to do with how and when he was infected.

[quote]Where is the evidence he became infected because he was exposed to a Truvada resistant strain of HIV?

r218 what do you mean by 'The fact he claims his virus is resistant to one of the medications in Truvada has nothing to do with how and when he was infected.'

This is what immunologists were predicting so it should come as no surprise. As people here have noted, it's all dependent on behavior, and you can't change behavior just because the FDA approves an HIV treatment as an HIV prevention

the part where he details how is on his post from April 30 2015. It's pretty recent so maybe you're not aware of the resistant strains that are emerging:

"My gene testing results are in. It now makes sense why Truvada failed despite 100% adherence. The virus that I have is resistant to emtricitabine, one of Truvada's ingredients. I am not resistant to Tenofovir, the other ingredient, which my doctor thinks is why my viral load is so low (1000) even after an estimated 3 months of infection.

It also turns out the virus I have is resistant to lamivudine and rilpivirine, and is possibly resistant against didanosine. It looks like this is going to greatly limit the medications I can use since most of the "gentler" treatment options contain lamivudine, ripulviriene, and/or or emtriciatabine. I'm pretty terrified about it right now.

I actually can live a perfectly happy life not having unsafe sex. It's just ingrained in me to compassionately protect myself, and my partners by using a condom.

Decided I wanted to go on Truvada. The fear of HIV is what has kept me negative for over a decade. It's also made me absolutely terrified everytime I go in to get tested. And I'm probably the most careful guy I know.

Once my new insurance was figured out and I was assigned a doctor, I met with the nurse practitioner. She had never heard of Truvada or PreP. She wanted me to see the doctor. He had never heard of it either. I went in armed with a lot of information because I don't want to wait up to 3 months before I get into to see a specialist. Anyway, he had zero idea that a pill existed. I went in with a lot of information, guessing this might be the case. I was ready to argue so that I'd walk out with a prescription. He understood I didn't want to wait up to 4 months for this protection, since it takes 30 days after starting to be effective.

Instead, he asked that he have time to research it and I agreed to come back next week. That's totally acceptable, I don't mind he wants to read more about it and my behavior is relatively low risk anyway.

I guess I'm writing this because it shows just how unaware the medical community, let alone the gay community is about this medication. Everyone needs to know about Truvada and it will take several years before there's full awareness and education. Those guys who put "negative on PreP" in their profiles are doing the community a great service. Up until last year, I literally thought it was a medication best suited for junkies and cumdumpsters who could risk side effects since they were likely to be infected otherwise. Seeing lawyers and doctors having it listed in their profile made me rethink it, as did finding out that some of my friends were on it.

Sorry to rant, just sad to have the experience of sitting across a desk from a doctor (practicing right outside of a major metropolitan area!!) and the look of befuddlement on his face upon hearing there was a drug to prevent HIV transmission.

[quote]Seeing lawyers and doctors having it listed in their profile made me rethink it, as did finding out that some of my friends were on it.

You do stuff because doctors and lawyers are? That just doesn't sound believable. You sound like you are trying to soften the blow of the statements above and distract from the unanswered questions, which are critical.

You're also flat out wrong about ' ...upon hearing there was a drug to prevent HIV transmission'. Truvada does NOT prevent transmission. It inhibits the virus' ability to replicate. Condoms prevent transmission. Truvada is claimed to prevent it from taking hold. HIV will still enter your body. None of the Truvada salespeople here can answer how long it stays in your body, whether you can pass it to others, or how likely Truvada resistance is if you skip doses.

After reading some of the stories and links here, especially the guy who seroconverted while on prep and clearly got a virus that is Truvada resistant (meaning anyone can) there is no way i'd go near that drug.

R222 I think its too late. Most idiots are just going to keep saying it prevents transmission, mostly because they wish it did.

r221 I knew a lawyer who was also a cumdumpster and a meth addict. Now dead.

So you're an idiot if you think that doctor/lawyer and cumdumpster/junkie are somehow mutually exclusive groups.

What a dumb statement to make. Even dumber if you're telling the truth, which is doubtful.

r222, you keep insisting that the virus lives in your body, it just can't replicate, insinuating that the virus will live there forever and that you'd have to take PrEP forever to keep it from replicating. That is complete and utter nonsense. please provide links from a reputable source for that info because i've never heard anyone say that including my doctor.

oh and by the way, it does not take 30 days for PrEP to begin being effective. my doctor said to take it a couple of days before having sex. there have been recent tests of guys just taking it a couple of hours before having sex and it provided protection. and these tests were done on guys who do not take it every day. the tests are preliminary but it looks to be a drug that possibly could provide protection by just taking it the afternoon before you have sex at night.

Please provide links on these recent tests r226.

There is not a reputable doctor or HIV specialis who would advocate prep as you describe: taking it a few hours before a night of sex. You do a lot of damage by spreading these rumors.

And you should switch doctors because your current one is a moron.

my current doctor is one of the leading AIDS specialists in the city. shows what you know.

here's the link

Bought of studies by bigpharma to keep the sales going.

What is your doctor's name r228? Put your money where your mouth is.

why, do you think I"m lying? you certainly are combative over this issue. why are you so personally invested in whether guys take Truvada or not? How does it affect you one way or another? Or do you just enjoy being schoolmarm and telling others what they should be doing?

If I weren't partnered, I would absolutely take Truvada. Like OP, I enjoyed the freedom of the pre-HIV/Aids world. Good for you OP.

The virus doesn't live forever of course... but it can live long enough people. The data on this is actually pretty hazy. And what do you mean how does it affect you R232? Of course this can have an effect on entire gay communities. One irresponsible user could fuck you all up.

r233 is that a parody post?

[quote]Those guys who put "negative on PreP" in their profiles are doing the community a great service.

Yeah, and those gay guys now in their late 40s-50s who lived through the big AIDS die-off, and have responsibly used condoms, and had safe sex for the last 30 years have also been doing a pretty good job too. Imagine that!

[quote]why, do you think I"m lying? you certainly are combative over this issue. why are you so personally invested in whether guys take Truvada or not?

I'm not personally invested in whether guys take truvada. That is a personal decision for each person to make.

I am personally invested in people who come to gay boards and say they heard that studies say Truvada doesn't have to be taken regularly, that it will protect you if you take it that afternoon for a wild night of fucking. Then the person who makes that claim refuses to back it up by citing either the study or the doctor who said it.

If you can't back up your claims it suggests you're lying r232. Why do YOU have such a vested interest in making sure people believe in Truvada as prep, r232?

Could it be because of all the unanswered questions and the documented accounts of guys getting HIV even while on Truvada? Is it tarnishing the brand you're working so hard to protect?

Moron, I posted the link from the study.

And I NEVER said that you should take it that way, I said there is a study that says it works that way and that we may be headed for that.

I see now that you just make shit up and spout of because you like the sound of your own typing, but you don't know shit.

r238, I apologize, I did not see the link to the study you posted.

But there are still unanswered questions. The link you posted said study results would be available in early 2015, are they out? The post was from October 2014. The post about the guy who seroconverted while on prep due to a resistant strain was from April 2015.

So the big unanswered questions : if you take truvada as that Advocate article describes could you be helping create a resistant strain? If you take it and get infected how long does HIV live in your body?

I haven't heard another word about that study; I presume they are doing another similar study to see if they get the same results. It would certainly be earth shattering if it were true that you could take it mere hours before a sexual encounter and be protected.

If you somehow manage to get infected despite taking Truvada with strict adherence as that man claims, then I don't know what the answer is. It's possible that he was already infected when he started taking the drug but the results didn't show it. That seems more likely to me than his explanation for one reason: If it were that easy to get infected with strains resistant to one of the drugs I think many more people would have done so. The fact is, they haven't. That alone makes me suspicious of his story as he told it.

An interview on Betablog with Dr. Albert Liu from the San Francisco Department of Public Health features these quotes:

"Truvada for PrEP works by blocking an enzyme called HIV reverse transcriptase. By blocking this enzyme, it prevents HIV from making more copies of itself in the body. Without the ability to replicate, the virus is unable to take hold and is cleared from the body. It’s important to remember, though, that PrEP may not be 100% effective in preventing HIV." and "You cannot serve as a type of “pass-through,” where you carry HIV from one partner to another while staying uninfected yourself."

Also from Dr. Albert Liu, and relevant to the story of the poster who acquired HIV while on Truvada:

As Truvada contains two medications (emtricitabine and tenofovir), it is important to consider whether your HIV-positive partner has resistance to one or both medications in Truvada. In animal studies, Truvada was effective in preventing infections with a virus that was resistant to emtricitabine alone. However, there was reduced protection with Truvada PrEP in cases of tenofovir resistance. Fortunately, resistance to tenofovir is still relatively uncommon in the community. As we don’t know whether results seen in monkey studies will apply to people, additional studies in humans are needed to address this important question.

Whatever drugs you are on, stay away from the Poz guys.

I take it as an added dose of insurance, not a license to practice unsafe sex. I'm mostly an oral top anyway; not much into anal and the riskiest thing I usually do is blow a guy without a condom. The rare times I do anal it always involves condoms, but it's literally been years.

I'm in a long-term open relationship with another "Truvada whore." I probably have less than 40 sexual encounters a year outside of my relationship, with about 3-4 "regulars" and a dozen or so randoms, not counting my partner who also hooks up on the side. I am tested regularly, every 6 months, and I have remained negative for over 20 years of sexual activity. I intend to remain that way. The only STD I've had was a weird skin infection, moscullum? It went away after treatment. I realize I'm lucky and still taking risks, and I could wind up with something any time I play around, but HIV would be a shock.

You can call me a whore, but I prefer to be called a slut. Whores charge; I give it away for free.

I would agree that there are enough questions that taking Truvada would best not be used as a license to take raw loads up your ass from multiple partners. I take it as an extra insurance policy in case there is a slip up. That's it. But each person has to decide for himself.

One new wrinkle to gay health worth mentioning: They are now suggesting sexually active gay guys get tested every three months.

One of the guidelines of Truvada prescribing is that patients have to come in for full STI screening as well as blood work every three months before they can get the new prescription.

Apropos the above comments about how so many white guys are on it but so few Latinos.

Here's the takeaway from that:

"AltaMed’s efforts are being paid for by Gilead, the pharmaceutical company that makes Truvada. The goal of its $80,000 grant is to help 100 high-risk gay Latino men throughout Los Angeles County get prescriptions for PrEP. The grant pays for the outreach but does not cover the cost of the medication."

They are spending 80K on marketing to get 1,300,000 in revenue (goal: 100 new customers at $13k per year).

Ka-ching, indeed.

R249 Well said.

R249 - One of the things I find interesting, and most of the anti-PrEP army (who sound more and more like global warming deniers) ignore, is that there is support for PrEP from medical professionals who have no financial interest. The Public Health community. International, national, state and municipal public health programs support PrEP. That information has already been posted in the this thread. Strictly form a funding perspective they probably have more to lose than gain by endorsing PrEP. It's like needle exchanges and birth control education for teenagers - effective programs that bring with them the wrath of the religious right.

How about all the liars that will claim to be on PrEP only to get some action? At least I can see when you put the condom on, it is verifiable, how am i suppose to confirm you are on PrEP?

r251, why are you trying to associate examination/criticism of prep with completely irrelevant groups? Global warming deniers and the wrath of the religious right? Huh?

It seems whenever there are good points or questions about Truvada someone like you pops up to confuse the issue with your weird guilt-by-association memes. It's hard to imagine how any regular person would have such a vested interest in preserving Truvada's marketing appeal.

Please explain what the 'anti-prep army' has to do with global warming deniers? Also there is no 'army' there are just some people bringing up valid questions that nobody seems willing to answer.

anti-preppers could be costing lives, that's what the problem is. This has been shown to be NINETY PER CENT EFFECTIVE against HIV----THAT IS MORE EFFECTIVE THAN A CONDOM IS. But the more you anti-preppers (who are coming off more and more like the anti-vaccers) screech and bray about imagined bogey men and exaggerated side effects, the more you keep people from exploring something that could potentially keep them negative.

As far as the cost goes, I'm actually getting Truvada for free. My insurance covers all but $200 and Gilead is covering the rest. It's not costing me a penny. And if Gilead weren't paying it, the city would. In fact, I don't know anyone who is paying over $30/mo for their Truvada prescription.

[r252] Either you have posted this question multiple times or there are other people who think exactly like you (which I would find really sad).

You ask "How about all the liars that will claim to be on PrEP only to get some action? At least I can see when you put the condom on, it is verifiable, how am i suppose to confirm you are on PrEP?"

YOU DON'T. You are responsible for you. Just like before PreP. There is no difference between unprotected sex with someone who claims they're "on PreP" or just claims "I'm neg and recently tested!" Either way, you are not required to fuck them without a condom. Doing so would put you at risk for contracting HIV because you have no way of knowing if they're telling the truth.

[quote]anti-preppers could be costing lives, that's what the problem is. This has been shown to be NINETY PER CENT EFFECTIVE against HIV----THAT IS MORE EFFECTIVE THAN A CONDOM IS.

No, the problem is that the people who take it will slip up and won't be consistent (as many people have pointed out over and over). THAT is what will cost lives, not the 'anti-preppers'. The entire plan depends upon an 'ecosystem' of prep-protected men who do not miss a dose and never seroconvert.

Your figures on prep vs condoms is really an unknown. And the official line is it must be used with condoms to provide extra protection but we all know the word on the street is it's a license to bareback.

This will all end in tears.

R255 I'm not fucking anyone without a codom. Simple as that.

R253 - I've explained this before. You're basing your opposition to PrEP as a sound public health policy on speculation and single cases. Like global warning deniers and religious fanatics you grasp at straws and ignore the predominant scientific conclusions.

In short you can't lay out a path that leads you to conclude there is more of a risk posed form drug resistant HIV strains developed in people taking PrEP than the risks without PrEP. Your argument starts with the premise you don't like ke PrEP and then you go looking for reasons not to like it.

If you want to turn your back on science, fine. But why do you want everyone else to do the same? Who are the other groups that want people to turn their backs on science? Global warming deniers and religious fanatics.

Whether it works as advertised or not I'm sticking to condoms till the long term effects are known.

[quote]In short you can't lay out a path that leads you to conclude there is more of a risk posed form drug resistant HIV strains developed in people taking PrEP than the risks without PrEP. Your argument starts with the premise you don't like ke PrEP and then you go looking for reasons not to like it.

^^^THIS^^^

It's an added line of defense, not a license to bareback like its the 70s again.

They'll learn...It will be too late but they'll learn.

r259 the science backing up the public health benefits depends completely on adherence as outlined in r256.

Others have made the same point: It is adherence that is the problem, whether you are talking about condoms or prep.

Truvada was designed to add a layer of protection. Condoms can and do break. Why would a sexually active gay man not use every possible protection available, if you can afford it, and you're not in a monogamous relationship? As I said above (and no, it wasn't a parody post), if I were single I'd absolutely be taking it.

[quote]Truvada was designed to add a layer of protection.

But people are using it instead of condoms, not in addition to. When you use it with condoms, it's no better than condoms alone.

You PrEP queens deserve your new aids. I am surrounded by diseased idiots!

R265 ummm no. Truvada is most certainly better than condoms alone. if we had had something like Truvada back in the 80s we probably would have scoffed at it like some of you are doing. We didn't even use condoms! Look, all I'm saying is that it's an added protection, not meant to be a free ride. Don't discount it out of fear.

"When you use it with condoms, it's no better than condoms alone."

That's not correct. You've got at least a 9 out of 10 chance a condom is going to work. But if it fails, you get to play those odds all over again. And that's only if you're with an infected partner. Guys on PreP need to be tested 4 times per year in order to get the prescription, which is more often than most sexually active guys get tested for a full STI panel. There may be an overall reduction in STI's based on this required interval testing as opposed to guys getting tested when they get around to it.

[quote]You've got at least a 9 out of 10 chance a condom is going to work.

Bullshit!

I love the sly "Condoms Fail" trolls, sly insinuating that they are risky. The main reason condoms "fail", is because you haven't unwrapped it and put it on your dick. We ALL know that. I've been using them since 1984, and never had one break, although the number of times guys have tried to sit on my bare dick is too many to count!

269 - I didn't say they condoms didn't work. I wrote "at least 9 out of 10 chance". Studies show condom effectiveness is somewhere between 85-99% effective. I think it's fair to say it's probably in the high 90's. I was not sly nor did I insinuate anything.

Condom usage has been slipping for years. It's the result of hiv being viewed as a chronic illness as opposed to a deadly one. It will continue to slip. EIGHT OUT OF TEN young gay British men admit to having had unprotected anal sex with a stranger. And Truvada isn't paid for by their single payer insurance yet. It's not a factor in that number. My guess is that it's just as high in the U.S., but we're so repressed when it comes to sex that fewer youngsters are willing to admit to the behavior they engage in.

Here's what will happen. All these guys so eager to fuck bareback will get on Prep, things will be all Yay! cream pies for everyone! Then something new and nasty will pop up be it a new strain of resistant HIV or some other new nasty thing and we'll end up right back where we started. That old saying about history repeating itself is an old saying for a reason.

The difference between PrEP and a condom is that remembering/choosing taking the pill happens when you're alone in a non-sexual situation, sober, etc. The choice about using a condom is often made in the "heat of the moment" with the sexual partner there, when judgment may be clouded by any number of factors. Not an excuse, but an explanation.

[quote]Condom usage has been slipping for years.

And truvada prep makes that WORSE not better. Because now guys will think they can take this pill and forget the condoms. All the truvada marketers and cheerleaders know that is exactly what is happening.

Northwestern University is researching the viability of a PREP implant they hope would last up to a year. That would certainly address compliance concerns. (Though I tend to agree with R271.)

An implant would be amazing and that would basically shut up all the anti-Preppers and their screeching about adherence.

A Truvada shot is currently being tested, its only needed 4 times per year.

R271 - your post is foolish.

It's the way nature works R277, Diseases adapt and new viruses and bacteria come along.

R278 - no it's not.

Take it up with nature.

Mother nature always bites hard and science and drug companies try to keep up. 40 million people have died of AIDS and still people are trying to outsmart it. The rest is luck and straight facts about being the receptive partner of raw loads. Roll the dice.

Actually the adaptation is the result of a random mutation that happens to give the virus resistance to whatever chemical kills it. The more a virus replicates the more chances for mutation to happen and the more chances for a lucky resistance to develop. This may be part of the reason why strict dosing adherence is so important. You don't want to give it chance to get lucky with a beneficial mutation. However the virus wont "adapt" in the same way we adapt, like for example, when we are cold we learn to build a fire to keep warm.

Still using condoms here ............ trying to avoid EVERYTHING you can catch ...... until there's a pill to help prevent EVERYTHING, there's no biggie to slipping on a condom. Seems to have been enough all these many years.

Sticking to condoms here too, until there's a cure for HIV and other STDs I'm not going to risk my life and health on a pill.

Went to the nurse practitioner at my dr's office, she hadn't heard of it. Told me she wanted me to see the doctor.

Waited two weeks for dr appointment. I go in, he's never heard of it (I told his staff in advance, "hey he might be unfamiliar with this drug, please let him know so he can research it" and they didnt). So doctor says "let me check out the information on this drug, come back next week." OK.

Next week my appointment is cancelled.

I come in the next week. He's got bad information on the drug, he didn't look up PreP, just the medication (Basically he tried to explain to me that people are still infected with hiv but remain at low/undetectable levels until they stop taking the drug at which point the virus can progress--not accurate.)

I ask for a referral to an infectious disease specialist. My insurance company approves it and assigns me to a doctor. I call the doctor's office and tell them why I am making the appointment. The receptionist tells me the doctor refuses to accept patients for that purpose (they've apparently gotten lots of calls about this).

Back at square one.

R285 Sigh. I don't even know where to begin. I am just going to say that unless your bodily fluids are FLOODED with Truvada preventing the virus to enter a TCD4 cell and inserting its cDNA into your cells DNA is mighty difficult. That is why the drug keeps low levels of HIV, because it cannot be present in every part of your body at the same time in sufficient concentrations to kill inhibit the polymerase. It could happen if you are lucky, but simple chemical diffusion makes it highly unlikely (and diffusion is what keeps us alive so we can't stop it). You are safer taken it for life after you start.

Wow very sleepy and I murdered that paragraph. Be gentle oh grammar lords.

R285, you need to find a gay male doctor or at least one who treats large numbers of gay men. Why are you seeing some sheltered hetero doctor when you're a sexually active gay man? If my doctor said he never heard of Truvada I'd walk out.

R286 - I was under the impression the Truvada prevented the HIV from multiplying and then is cleared from the body. Apparently I got my information from the link below. Is the link not accurate?

No one would choose to take a damned pill (when they don't even HAVE HIV!) over using condoms unless they are sluts, mentally ill, self-loathing or a combination thereof. That pill can cause liver damage, massive other health issues, facial wasting (just like any HIV drug) and heaven knows what else. Why would someone ingest that if they did not HAVE to? Oh yeah, sluts with low self-esteem. I forgot.

So for my freelance lifestyle friend who is on Medicaid and unemployment most of the time, it's $3/month.

But for someone uninsured I know, Duane Reade/Walgreen's sent a "your prescription is ready" email. The cost for a 30-day supply? Over $1,600.00. That prescription didn't get picked up.

r290, you are mentally ill. please get help.

YOU DO NOT HAVE TO TAKE TRUVADA FOR LIFE IF YOU START TAKING IT. Whoever it is who keeps posting that is full of shit so STOP IT. You are spreading misinformation and being a dickhead.

Truvada is a lot more expensive than condoms and insurance companies are catching on quick not to cover it given how expensive it is and that it's being used a recreational drug. The whole thing isn't really a concern for me at this point married and settled down, but if you use it don't think it's replacement for condoms. Just how HIV snuck up on us, there is a reasonable chance something else will that the drug won't even be close to protecting you from. New bugs and mutations of existing ones is just part of nature. I'm not even the paranoid type, but it's just smarter to use a barrier for high risk sex. It's just also too easy to use drugs incorrectly. Condoms you know in the moment no matter what it's on and not if you remembered to take your dose that day or week.

It's $7 with my insurance. We have many paranoid alarmists posting here it seems.

It's free after the 1st $50 co-pay with mine.

My newly assigned primary care doctor wasn't familiar with Truvada. (I am in the process of switching doctors so I can see one who has gay patients). He referred me to an infectious disease specialist. I called to make the appointment...I was told they don't take appointments for that. I called the primary care doctor, he called their office and told me he had straightened it out, I just needed a new HIV test. I get the test results, have them faxed over to infectious disease specialist.

Just called back to make my appointment. Spent several minutes on the phone with the receptionist. She didn't know what Truvada as PrEP was. I asked her to google it, she said "I'm not googling anything." She went to speak to the doctor and came back and said "he doesn't prescribe Truvada to patients who are HIV-". I pointed out that the receptionist had

I live right outside of a major city. I will eventually track down a doctor who has other patients on the drug and takes my healthcare plan, but I feel really, really badly for the people who are seriously at risk of contracting HIV and get the same runaround as I've gotten.

Wow. The arguments against PrEP sound like the arguments conservatives make about birth control and sex education at schools. Heck, conservatives were claiming that giving girls Gardisil would increase their sexual activity thus exposing them to more STIs. All this is bullshit. PrEP offers another effective tool against increasing HIV rates. When discussing this we need to differentiate between "the way it should be" and "the way it is." Should everyone be using condoms? Yes. Is everyone using condoms? No. We can either ignore that fact or we can embrace the tools we have at our disposal. I am on PrEP and still use condoms. However, the stress I used to encounter when taking an HIV test is gone. I enjoy sex a heck of a lot more having that extra barrier of protection. Many HIV negative guys bareback when not on PrEP. That's a fact. Is it irresponsible? Absolutely. But once again, is it a reality? Yes, and that is why they should be on PrEP. You think you are in a monogamous relationship and are barebacking with your partner? You should be on PrEP since partners lie and cheat all the time. Even with inconsistent medication adherence it offers some protection against HIV. The great thing about being on PrEP is that you are required to get periodical HIV tests, meaning those who are infected because of poor medication adherence will be taken off PrEP immediately and hopefully provided with stronger HIV meds. Facial wasting and fat distribution haven't been documented in Truvada as used for PrEP, however, there is a warning on the medication because it is required by law to be listed since it can cause facial wasting on rare occasions for HIV positive patients taking a stronger form of Truvada. Liver problems are also incredibly rare, your liver is monitored periodically, and you would be yanked off the medication immediately if there was cause for concern. It is important to be skeptical about such things, but to discount PrEP as a viable form of HIV prevention is at worst, shameful, and at best, disingenuous.

Thank you, r298.

I think its disgusting that doctors who make an amazing living off treating HIV are refusing to prescribe the medication. I don't think they're looking to make more money but it's pretty hypocritical and dangerous.

I expected that some doctors would be hesitant to describe it because my behavior is relatively low risk (but still higher risk than normal due to another health condition). I did not expect to be refused an appointment outright, especially without the doctor meeting with me to evaluate my risk factors and go from there.

When did drug reps start posting on DataLounge?

R297 illustrates the importance of having a gay or gay-friendly doctor. I don't know how I would have gotten the healthcare I did without a gay doctor. I can talk to him about anything and he never flinches. He told ME about PrEP, told me about the hepatitis vaccines and why gay men need to get all of them and stay current on them, etc. They just know the right questions and have the right answers. I couldn't imagine going to some hetero Doctor I picked off of google because he's 5 minutes away and takes my insurance. Do your research and find a gay doctor or a doctor with a predominantly gay practice. Most have offices in the local gayborhood or advertise in the local gay paper.

How do you go about finding a gay or gay friendly doctor?

well if you live in a large city, it's easy. if you don't, you'll probably have to travel to the nearest large city to find one.

I've written before about the long trek to getting this medication. And while i should be seeing a gay friendly doctor or specialist, my insurance options are limited and I can't switch plans right now. I live directly outside a massive metropolitan area.

This happened today.

9AM - Call from nurse practitioner at primary care doctor's office. She says she spoke to the specialist's office (which had already turned down my appointment twice, despite my referral) and I can schedule with them. She said this last week also and they wouldn't schedule me.

9:30 - I call specialist's office. They know who I am, what I want to come in for, and tell me that their doctor will not prescribe Truvada to HIV- people under any circumstances, including being in a sero-discordant relationship.

11:00 I call primary care doctor's office back, let receptionist know what happened. She calls me back to tell me she's gotten an emergency authorization for an appointment at another infectious disease doctor's office. She informs me to lie and tell them I just had unprotected sex with an HIV+ partner because she thinks that might get me in there today or tomorrow.

11:15- I call to make my appointment with Infectious dr #2. They have received the faxed authorization form that says I just had unprotected sex with an HIV+ person. They offer me an appointment in November.

12:00 - I call primary care dr's office back. I have already had three appointments on this. They ask me to come in Thursday, but that the doctor probably won't prescribe the medication because he wants a specialist to do it.

That is OUTRAGEOUS!! I cannot believe what you are going through. What the fuck is wrong with your doctor that he himself won't prescribe it? That's idiotic. You don't need a fucking specialist to prescribe Truvada. Why doesn't he just do his fucking research? Where do you live? At least, which state?

R306 - I live less than 25 miles from West Hollywood. A large part of my specific problem is just having been assigned to a doctor who isn't in much and has been very sick during these past few weeks. The doctor and nurse were supportive of the idea of going on the medication (although I'd argue they don't seem to know how to properly conduct a risk assessment). Again, I'm limited in my healthcare plan and will switch doctors at some point soon. But it can take months for that process to unfold, I want the medication now.

Resistance and ignorance is shockingly coming from the infectious disease specialists (and their receptionists/assistants).

I go in to see the doctor again tomorrow. I will have all the information ready to go on my laptop, in addition to the PrEP hotline (where doctors/nurses are ready to explain the drug, prescribing, and protocols for those who are unaware). If he won't prescribe it for me, I am going to keep a smile on my face and tell him I'm not leaving without it. I'm trying to think of a way to non-confrontationally make it clear they'll have to call the police to have me escorted out. I think it would be fun to be the first patient arrested for being refused Truvada.

We need to get the word out about this medication. In our gay bubble, we're all well aware it exists and the arguments on both sides. Clearly, that bubble is very very tiny. I don't even care that a specific infectious disease doctor refuses to prescribe the drug--I'm horrified that their office isn't being contacted daily by patients asking about it.

I'm going on it for largely psychological reasons. HIV terrifies me and fear of the virus infects every single sexual encounter I have ever had. I also have some health issues that could escalate my exposure during "low risk" activities like oral sex. I would have loved to discuss these concerns with one of the infectious disease specialists I was referred to, but they won't schedule me for an appointment.

BREAKING: The first "real world" study of Truvada is in. 600 high risk patients in San Francisco tracked over 32 months. ZERO NEW HIV INFECTIONS!!!!!!!

There are some caveats. The previous finding that Truvada doesn't change sexual behavior is refuted... Condom usage dropped precipitously (about 40% of subjects used condoms less than before). STI infections also went way up. There were only 2 hepatitis infections, which may be statistically on par with what would be expected in a high risk behavior population anyway. Or possibly it's lower since these sexually active patients are getting full STI screenings 4x per year and finding out/getting treated before they rack up a lot more partners.

600 patients, ZERO HIV infections. WOW.

(How many minutes before a troll tries to equate an easily treated chlamydia infection with HIV?)

You sound like a paid advertiser R308... WOW SORRY.

Yeah, 309. Nothing special to see here. Keep moving....

I guess you haven't watched any of your friends become HIV+. Or been aware that your negative friends occasionally behave in ways that put them on track to become HIV+. I'm glad you've never had concerns for friends who were early adopters of Truvada because they seemed to put more weight into the studies that suggested a 99%+ effectiveness rate than numbers gathered from other studies.

I'm glad you never, ever had to worry about going in to take an HIV test and how a positive result might change your life. I'm glad you've never given a blowjob and worried that you brushed your teeth and gums too hard before you went out.

Guess you've never been in a relationship that is growing stale or even a strong relationship where you're wondering if your partner is being faithful to you. Glad you've never found out you've been cheated on. Or have had friends in the same situation who continue to bareback in "monogamous" relationships that they'll eventually find out were only monogamous on their end.

I'm glad that fear of HIV for yourself and the important people in your life hasn't had much of an impact on you and that today is like any other day.

Sorry, I can't type anymore, I'm late to pick up my check from Gillead.

That's great news R308.

r307, there are some wonderful gay doctors in Los Angeles. If you can possibly make your way to see them, they accept almost any insurance.

That's nice, you tramp.

30 percent of participants did contract at least one sexually transmitted infection within six months of the study’s commencement. This number jumped to 50 percent after one year. In addition, 41 percent of participants reported a decrease in condom use.

R310 Maybe you should pick up an additional check from MARY!

That new study that tracked men for 2.5 years and NOT A SINGLE MAN became infected with HIV while taking Truvada is kind of earth-shaking.

I started on it a few weeks ago. I knew that it could cause nausea so took it at night to sleep through any discomfort.

First night, had no problem. Second night I felt sick and eventually threw up twice. Next morning, I was fine. Haven't had any nausea whatsoever since.

good for you, r317. every single gay man who is sexually active should be on it.

I can't start a thread so somebody start one on RYAN GONZALES, a gay dude in Orange County who was the video editor for those Planned Parenthood videos!!!! A GAY GUY DID IT!!!! This is horrible. What's worse is, he's really hot. He's friends with friends of mine. I'm distraught.

I've never gone on Truvada. Kudos to the guys who have... I just don't trust it tho. I'm always worried the other shoe is going to drop.

Fuck off R320

R320/ 2015 bump troll also doesn't wipe.

R43 If you take your meds and are HIV+ you CANNOT develop resistance, my HIV doc told me just that and I believe her before some twat online. Folks need to stop listening to cranks on a bitchy gay forum. You do not know what you are talking about. There is no thing such as Superinfection either and has never been documented ever, look it up and get educated. God I can't stand gay men sometimes.

I suggest you acquire a copy of "Flowers For Algernon", dear. Oh, and read it.