Condom and bareback discrepancy

[+ BenjaminNicholas]

1 hour ago, ShortCutie7 said:

And this is why I don’t trust PreP on its own and will always rely on a combination of condoms and vetting/very rarely fucking.  I saw more than one “starred” Grindr guy’s status change from “on PreP” to “undetectable”.

PrEP works when you take it as directed.  These people don't.  They're idiots.

The pills work well.  Cabenuva even better. 

The active ingredient has been in circulation long enough for us to know that.

Trusting science isn't the issue here.

Edited August 25 by BenjaminNicholas

[+ BenjaminNicholas]

1 hour ago, pubic_assistance said:

LOTS of "undetectable" 20-somethings out there when you look around on Grindr.

These kids are all getting a rough lesson about pharmaceutical companies. THEY LIE.

Are there medical studies to link that prove they're lying about the current effectiveness of PrEP?

Edited August 25 by BenjaminNicholas

[ShortCutie7]

3 minutes ago, BenjaminNicholas said:

PrEP works when you take it as directed.  These people don't.  They're idiots.

The pills work well.  Cabenuva even better. 

The active ingredient has been in circulation long enough for us to know that.

Trusting science isn't the issue here.

Exactly, it’s not the science I don’t trust; it’s the margin of error in people taking it… how many of us know a woman who took birth control “as directed” and got pregnant anyway?  I would guess all of us… there’s an innate margin of error to literally anyone doing anything, even if they think they’re doing it right.

[+ BenjaminNicholas]

Just now, ShortCutie7 said:

 there’s an innate margin of error to literally anyone doing anything, even if they think they’re doing it right.

One pill a day is easy.  One injection every two months is even easier (for me, at least).

But- bottom line- it's up to everyone to protect THEMSELVES...  Not expect a stranger to do that for them.

There's still a weird anti-PrEP sentiment, especially from the old guard, but that's thankfully dying off. 

Medical science is truly an amazing thing  

[+ JamesB]

I'm on PrEP and still use a condom. While some might argue that if both the client and provider are on PrEP, it should be safe, I would never rely on a provider's word when it comes to my health.

[HockeyMan]

The drug companies aren't lying about efficacy. People just refuse to acknowledge risk reduction is not risk elimination. PrEP is not 100% effective and neither are condoms.

[pubic_assistance]

2 hours ago, BenjaminNicholas said:

Are there medical studies to link that prove they're lying about the current effectiveness of PrEP?

Yes.

Pharmaceutical company says 99% effective. 

Independent studies put it around 89% to 92% depending on the study. No one saying its not effective. But the drug industry makes it sound like a miracle. There is always a small risk of failure. 

Obviously skipping doses is your own failure not the drug. 

[+ sniper]

I seem to recall reading that when they've done studies and then drawn blood from the people who became HIV+, they determined that there was basically zero medication in their system, it was too low to have just been a skipped dose or two. And guys in their 20s aren't known for being on top of their health insurance and change jobs a lot.  The party gays who go to Fire Island to do coke and meth for a week straight while they powerbottom for a dozen strangers probably aren't packing their pills. Or pre-workout and/or those mega-fiber supplements for bottoming are making them shit the pill out before it's absorbed(that's why Pure For Men says take it at least 2-3 hours away from any medications.)

If you know YOU are taking it properly, you're safer than a condom, statistically speaking. But condoms do protect against other things.  Before there was also HPV to worry about but there's a vaccine for that too(which btw they raised the age on insurance for to 45 and you can still get it past then if you pay out of pocket. I was 46 when they changed the guideline...grr).

[KeepItReal]

39 minutes ago, sniper said:

  Before there was also HPV to worry about but there's a vaccine for that too(which btw they raised the age on insurance for to 45 and you can still get it past then if you pay out of pocket. I was 46 when they changed the guideline...grr).

You have our permission to lie about your age ... every gay man on grindr is doing anyway! 😉😉

[+ sniper]

13 minutes ago, KeepItReal said:

You have our permission to lie about your age ... every gay man on grindr is doing anyway! 😉😉

There's no lying to the insurance company...they know everything..

[Jamie21]

I’m surprised that guys forget to take it yet still do bb. If I wasn’t sure I’d taken it then I definitely wouldn’t do any bb. I just get into a routine of taking it daily, it’s easy. I get 6m supply free on the NHS and a prep check up every 3m. It’s no trouble. 

A client I saw recently who topped me bb told me afterwards that he wasn’t on prep. I told him I was, and had tested all clear (at a routine test) a few days earlier. He seemed happy to hear this but I said to him the prep is to protect me. He should get on prep if he’s doing more bb sex to protect himself. He didn’t seem to realise this which I found very worrying. 
 

[pubic_assistance]

3 hours ago, sniper said:

they've done studies and then drawn blood from the people who became HIV+, they determined that there was basically zero medication in their system, it was too low to have just been a skipped dose or two.

I'm sure there are plenty of "party boys" who lose track of their meds for days at a time while snorting meth and "taking loads".

But -

Those aren't the only people contracting HIV while on PreP.

If you take it without missing a dose your chances of infection are small. However research shows that only 50% of the population of gay men who are prescribed the drug take it every day without fail.

[+ sniper]

3 minutes ago, pubic_assistance said:

I'm sure there are plenty of "party boys" who lose track of their meds for days at a time while snorting meth and "taking loads".

But -

Those aren't the only people contracting HIV while on PreP.

If you take it without missing a dose your chances of infection are small. However research shows that only 50% of the population of gay men who are prescribed the drug take it every day without fail.

The PreP adherence stats are likely strongly skewed by the party boys because initially they were the only ones who met the prescribing criteria. I'd expect better of most of the hobbyists here who probably tend to be above average in the characteristics that facilitate adherence.

I don't actually fuck all that often and should probably consider the 2-1-1 regimen but I think taking it daily is easier to remember and less likely to screw up than when the norm is NOT taking it.  I have missed a dose on occasion but never two in a row or even in the same week.

[pubic_assistance]

1 minute ago, sniper said:

I'd expect better of most of the hobbyists here who probably tend to be above average in the characteristics that facilitate adherence.

I would tend to agree with that statement.

The issue of party boys is also why I immediately delete any profile on Grindr or Rent.men etc that even discreetly mentions partying.

 

[soloyo215]

What an interesting read this thread has become. I love this conversation. I don't see a lot of consensus, but I personally have learned a few things.

My own position about BB/condom use is similar to some of those who have posted here. I personally don't judge other clients who prefer a higher level of protection. That said, I don't think is realistic to expect no (or minimal) risk while hiring people who are in a high-risk area of work. To me is more a matter of "comfort" (what you believe your appropriate level of risk is).

I also agree with the recommendation that if you are comfortable using condoms, bring some yourself, It's better to have extra than not having any.

Edited August 26 by soloyo215

[DWnyc]

14 hours ago, pubic_assistance said:

I would tend to agree with that statement.

The issue of party boys is also why I immediately delete any profile on Grindr or Rent.men etc that even discreetly mentions partying.

 

Also applies to remaining in undetectable status for those positive Ie missing medication can change that 

Again the risk here is from the individuals adherence rather than in the drug efficacy (which should be studied but is a different issue)

[DWnyc]

I can empathize with those who say “I don’t trust science and will still use traditional precautions”  especially those older who have seen the worst years of the pandemic in person. Sometimes this include skeptics on potential negative side effects PrEP (eg on kidneys) with not enough time since launch to assess long term effects. 

However, I don’t get another demographic I see  frequently: “PrEP seems to work for some, my risks go down as people taking I are less risky for me”.  Particularly among those who ditch or never used precautions such as condoms at all. 

And totally baffling:  those who lie (ie those who aren’t on PrEP but say they are and/or willing to use condoms).

I’ve heard rationale l like: 

”to shut up the PrEP n*zis” (which used to be the condom n*zis”

”I will eventually (take PrEP), I guess, just don’t want to miss out till then, my risks are really low”

”I hardly ever fool around outside of X, Y, Z (supposedly safe or celibate behavior)”

”I’ve been (not on PrEP) for years without problem, you know some people are just immune…”

”If other people want to believe something someone they don’t know tells them, isn’t it on them?”

 

 

[DWnyc]

22 hours ago, JamesB said:

I'm on PrEP and still use a condom. While some might argue that if both the client and provider are on PrEP, it should be safe, I would never rely on a provider's word when it comes to my health.

Should be about anyone’s word - not just that of a provider.

Some providers may lie or be unaware of status but typically I suspect the better ones are more vigilant about testing (and not just for HIV) and do so more frequently than average. So the window between a negative result and something unfortunate for them when they can transmit may be lower than for the average population with high frequency risky behavior. 

[+ JamesB]

12 minutes ago, DWnyc said:

Should be about anyone’s word - not just that of a provider.

 

Agree.

[+ BenjaminNicholas]

21 hours ago, pubic_assistance said:

Yes.

Pharmaceutical company says 99% effective. 

Independent studies put it around 89% to 92% depending on the study. No one saying its not effective. But the drug industry makes it sound like a miracle. There is always a small risk of failure. 

Obviously skipping doses is your own failure not the drug. 

Please link to those longterm studies with the discrepancy.

[+ BenjaminNicholas]

23 minutes ago, DWnyc said:

And totally baffling:  those who lie (ie those who aren’t on PrEP but say they are and/or willing to use condoms).

I’ve heard rationale l like: 

”to shut up the PrEP n*zis” (which used to be the condom n*zis”

”I will eventually (take PrEP), I guess, just don’t want to miss out till then, my risks are really low”

”I hardly ever fool around outside of X, Y, Z (supposedly safe or celibate behavior)”

”I’ve been (not on PrEP) for years without problem, you know some people are just immune…”

”If other people want to believe something someone they don’t know tells them, isn’t it on them?”

 

 

Certain people have always been fucking idiots. It's just the natural state of humanity. 

Natural selection usually takes care of these people.  

The problem remains that these are the assholes who contract and spread HIV. 

 

[DWnyc]

16 hours ago, sniper said:

I'd expect better of most of the hobbyists here who probably tend to be above average in the characteristics that facilitate adherence.

 

Having said that they need to get to the point of having care options to follow. 

I’d say many hobbyists (don’t know about %) - are also unlikely to be on PrEP for broader “discretion” reasons such as fear of a secret part of their lives being revealed / recorded by insurance companies / their doctor

 

 

[ShortCutie7]

5 minutes ago, DWnyc said:

 

I’d say many hobbyists (don’t know about %) - are also unlikely to be on PrEP for broader “discretion” reasons such as fear of a secret part of their lives being revealed / recorded by insurance companies / their doctor

 

 

That is one of my main reasons for not being on PreP and being a “condom n*zi”- I have the same doctor as my family, and my (very infrequent) sexual activity is nobody’s business.  I’m on one med (for an unrelated condition), and that’s one more med than I’d like to be taking.

[DWnyc]

22 hours ago, pubic_assistance said:

Yes.

Pharmaceutical company says 99% effective. 

Independent studies put it around 89% to 92% depending on the study. No one saying its not effective. But the drug industry makes it sound like a miracle. There is always a small risk of failure. 

Obviously skipping doses is your own failure not the drug. 

I haven’t gone through different studies though given my initial skepticism my doctor gave me a ton of reading material to go through when I first started PrEP and much of that covered tests before the drug companies got involved. Several National governments like South Africa and India turned around dire infection forecasts based on policy projecting from some of these studies. 

I’d add that even if those lower numbers are accurate in some scenarios - 89-92% - they’re astounding given infection and mortality rates in the 1980s. I’d say still a miracle - separate issue from any supplementary precautions to further reduce risk. 

 

[blck37]

Had a provider who top me with condom but bottom for another provider raw, all during a 3s play. Now that was funny to say the least 🤣