29 Jan 2011

Health: PEP and PrEP… reducing the spread of HIV

Category: Health

Post-Exposure Prophylaxis (PEP) is a four week course of anti-HIV drugs that you can take if you think you have JUST exposed yourself to HIV through unprotected sex or sharing needles.

If you act quickly after exposure to HIV you can, in most cases, stop the spread of HIV in your body. For the treatment to be effective you MUST begin the medication within 72 hours of exposure to HIV.

The medication is a combination of two or more anti-HIV drugs, medications that HIV-positive people take daily to minimize the virus’s ability to multiple.

It is not a good plan to depend on PEP for protection on a regular basis, it is intended to be emergency protection after accidental exposure or a temporary lack of good judgment.

In order for PEP to work you must take the drug for 28 days without stopping. Be aware though, taking anti-HIV drugs is often not without side effects, side effects such as nausea, migraine-like headaches, diarrhea, lethargy, tiredness, and vomiting are often associated with taking the medications.

Post-exposure prophylaxis is not going to significantly reduce the worldwide spread of HIV by itself. It is a short-term preventative measure intended to be used as an ‘emergency’ precaution. PEP is considered as a last resort in HIV prevention and should only be used when other methods of HIV prevention have failed.

If you need PEP or want more information please see your local HIV/AIDS heath care provider.

Pre-Exposire Prophylaxis (PrEP) refers to a form of treatment that can be taken before exposure to HIV, it is also sometimes referred to as a type of vaccine, although this is not 100% accurate. Pre-exposure prophylaxis has been studied in animal and human trials and is not yet available.

Results from a human trial published in late 2010 were the first to provide proof that PrEP may be a viable option for the prevention of HIV infection in humans.

There have been claims that people are taking tenofovir (an anti-HIV drug) before a high-risk night out. The U.S. Centers for Disease Control and Prevention carried out a survey at four gay-pride events and found out that 7 percent of the interview sample had tried taking tenofovir.

It has been argued that pre-exposure prophylaxis could have an enormous impact on HIV. Mathematical models estimate that if tenofovir PrEP was used by 90 percent of high-risk people and was effective 90 percent of the time, potentially the spread of HIV infection could be reduced by more than 80 percent in just a few years.


50 comments for Health: PEP and PrEP… reducing the spread of HIV

  • PEP is the only resort a person can take if they feel they have been exposed to HIV through unprotected anal sex or shared needle use.
    PrEP on the other hand is a chosen irresponsible last resort with what may be a 10% failure rate. Imagine playing Russian Roulette with a pistol which carries 10 rounds instead of 6. Eventually the loaded chamber is going to come around to shoot you in the ass, pun intended.
    With all the information out there today on protecting one’s self from contracting HIV and the availability of free condoms at just about every turn, there is really no reason to become HIV positive. However if you’re one of those who just has to experience the mental and psychological high of taking a raw load up your ass in order to make yourself feel sexually satisfied and fulfilled you WILL eventually be taking meds every single day for the rest of your life.
    HIV will be a burden to you for the rest of your life in so many ways you could never imagine. Not to mention the burden of worry and fear for your life it will inflict on your family. The stigma is unimaginable.
    Meds might have improved and be better today then they were in the past and one or two new ones might arrive on the market every year but they are NOT without a multitude of side effects, many of which you will need to take meds for to counteract those side effects.
    HIV is a very fragile and easy to kill virus. It dies immediately on exposure to saliva, air, even the weak solution of chlorine in a swimming pool. Today in America with the expectation of rape, with all the preventative information and condoms available you basically have to be recklessly stupid to contract HIV.
    Doing volunteer work for a local ASO I was fortunate enough to have all that information available to me, yet I was stupid and am the first to admit it. I have no clue who I contracted it from, as there were too many and I blame no one but myself.
    PrEP may sound like a good excuse to play recklessly but it’s not a good reason. You don’t want to walk in my shoes, believe me.

  • Important as HIV prevention obviously is, the blame game doesn’t help things and only serves to exacerbate the stigma associated with being HIV-positive.

  • Anything that will reduce the number of people that contract HIV…I’m all for it! An HIV Positive man myself, I understand that it’s all my fault. HOWEVER, unlike a previous poster, I didn’t take raw loads up my ass…sure I had unprotected sex on occasion, but there were NEVER any load exchanges, and the guy I got it from was an IV Drug user (didn’t know this at the time) and we had sex, he couldn’t stay hard (because he was so high), and so we decided to mutually masturbate. After he came, I got him to rub his flaccid cock around on my anus while I finished myself off…he didn’t penetrate me (he couldn’t) and he had already came…and I still ended up positive. If I had known he was an IV drug user, I would’ve suspected he was positive and would’ve tried to get some medication to do a PEP, but I didn’t have the info available. So, it’s not always a raw load taker that ends up with HIV, so stop contributing to the myths that are already out there, that’s why HIV is on the rise again is due to the myths that are floating around in the gay community. The ONLY safe sex is NO sex, and since that isn’t going to happen, again, I say I’m all for anything that will prevent transmission, whether it be vaccine, shots, pills, condoms, whatever.

  • I have worked in public health for 16 years, in STD prevention for 12 years. I have dual degrees in psychology (developmental and research) and am working toward an MPH.

    “Not Gonna Say” is correct, and I’d go further. The blame game is counter productive. The stigma aligned with HIV creates fear, which leads to irrational thought and behaviors. It frequently leads to a false sense of security, i.e. when someone checks off “negative” in their profile. There is no way of knowing for certain. In fact your more likely to take greater risks with someone that claims they are negative.

    Jerry, your type of rant is ubiquitous, exhausting and does more harm than good. On a personal level I hope you are getting therapy to work through your guilt and self loathing.

    It’s time to start being sensible about HIV/STD prevention, and ALL diseases for that matter. Disease doesn’t care what you think about people that have unsafe sex. Disease doesn’t care about your religion. Disease doesn’t care about the pigment of your skin. Only humans care to judge. And all the finger pointing, judging and preaching does is separates us, makes some of us valuable, other others damaged.

    Disease simply exploits our “virtues”, like water running into chasms finding its way into ever fissure we make.

    The fact that HIV is tied to sexual behavior makes people go absolutely crazy. And especially within our own “family” we start blame on another, judge, and find someone to blame. It is summed up in the popular question, “How did it happen today?” “How did it happen to you?” “Didn’t you read?” “Didn’t you know?”

    Stop it.

    • Stop freaking out. When an HIV positive individual takes their meds as prescribed, has undetectable viral loads, and no other STDs the risk of transmission is low, some reputable studies suggest it can’t even happen, regardless HIV doctor’s have told me it’s very low.

    • Be a skeptic. Don’t accept that just because someone says they’re negative or free of STDs, they are. In fact, they may not even know they’ve contracted a disease. The early stages of any disease are often the most contagious. This “negative” belief idea can prove more dangerous than being with someone who is positive and healthy.

    • More people will get HIV (and other diseases) and the meds are not the end of the world. Most the medicines are tolerated quite well. The side effects are diminishing and new meds are promising better results with even less problems. Hope abounds.

    • Some don’t like and won’t use condoms. Accept it. Some people are risk takers by nature. You worry about you, and let others worry about themselves. Stop judging Judy. She wouldn’t judge you.

    • Use condoms if you can. Know how to use them. There are other things to worry about besides just HIV.

    • Love thyself. Do your best to stay healthy in all respects. What would you tell the person you love most in the world if they came to you with your question.

    • Love others. Protect them from stigma. Protect them from fear. Protect them from disease and try to be a role model.

    • If you’re negative you can love and have sex with someone that is positive without fear.

    • If you’re positive you can love and have sex with someone that is negative without fear.

    • If you really want to stop HIV, in particular, stop stigmatizing people with the disease. Don’t preach before you listen, and be prepared to listen, and most importantly check yourself if you think you’re better than someone because of your status.

  • Im am very glad that they finally have consumed enough evidence to start releasing PREP. I has actually been around for quite some time but like every medication it had to be taken through a test trail. Although in my opinion it should hve been a no brainer that if antiviral meds can surpress replication that it would be prevent infection. The true question is if caught in seroceonversion the 90 onset of the virus can PREP combat the virus during onset…..@ Jerry…HIV is now known as a chronic illness not a burden and has nothing to do with your family.

  • at first I saw your a4a news, and i didn’t pay any attention, but after reading it I have found it very helpful, educational I thnk all should reand this,and I have been taught all guys that have unproteted sex should look at all guy as if they do and they should know what should be done.

  • Sorry but if you think you got HIV from a guy rubbing his cock around your anus you are fooling yourself or trying to fool others…that’s just not realistic medically. Also, the Swiss Federation on HIV/AIDS and others have concluded that HIV+ people who are on treatment and have an UNDETECTABLE VIRAL LOAD are NOT-INFECTIOUS. This doesn’t mean be careless and have unprotected sex…it means what it means!
    I knew this years ago because a year after I was infected and I achieved an undetectable VL level and after consulting with several physicians/experts, I had two additional children…all healthy HIV- as well as there mother.

  • Here’s an idea, lets all stop wasting money on “AIDS Research Fundraisers” and actually cure this shyt. Get money to organizations that are actually making progress. I find it hard to believe that after damn near 30 years of AIDS no one has come up with a solution to this problem. We can build airplanes that carry 500 souls across the ocean. We can build cell phones that do everything but walk. mean while, the scientific community is doing nothing but earning a pay check from research dollars and sitting on their asses. They (scientists) make all types of excuses for coming up short when it comes to this epidemic. I say we pull funding immediately from big drug companies and send it to the people who are actually making progress towards a cure.

    Think about it, pharmaceutical companies earn billions a year on treating the disease like a chronic illness. It’s more profitable to have people rely on your meds to stay alive than it is to just cure the illness all together. Don’t believe the hype!

    wake up, stand up!!!

  • Dude, if you think you own the truth, that’s your problem…
    We are trying to inform people here….
    And i personaly have a friend who contracted HIV doing Oral and another one who never fucked without a condom. So there are risks about doing anything unprotected…
    We are not ignorant like you say ! So please be polite or your next comments will be deleted !

  • for limited income how to you get the medications in Palm Springs, CA

  • Pozdude…he was positive, didn’t know it at the time (or didn’t care, but regardless wasn’t on medication), and I told you what happened between he and I…SO, unless the cum he shot seeped through my skin and made me positive, then the only alternative would be that he was rubbing his flaccid cock around my anus trying to get it in (without success) after he came. So, one way or the other that’s where I contracted my HIV from, because 40 days later I tested positive, and hadn’t had sex (other than oral) with anyone since my last test except for this guy. So, you can say I’m misinformed, lying, blah blah blah…that’s why gays get such a bad rap anyways because people like you are so quick to judge. How can you honestly sit in your living room and complain that conservatives shouldn’t judge you, when you yourself do the same thing everyday to your own people??? Quit being a hypocrite and start living a honorable life, free of judgmentalism, hatred, self-loathing, and discrimination.

  • I just hope that people don’t use these health findings as a escuse to bareback .some guys have the attitude ” oh well I can do what I want and there is always a pill for that “

  • JJ – It’s my understanding that to become positive, HIV must have direct access to your blood stream. Unless you had an anal fissure (which is very painful – you’d know it if you had one), or some other open sore around your anus, my guess is that you became poz from oral. I’m guessing you had some sort of open sore in your mouth that allowed HIV quick access to your blood stream before your saliva could kill it.

    Seems I’m too uncoordinated to chew without occasionally biting the inside of my mouth. My rule: No cock until it’s fully healed. Same for any other source of bleeding in my mouth. Standard advice has also been to avoid oral immediately after flossing or brushing too, since either can produce minor bleeding.

    I’ve had a whole lot of sex over the last 30 years and my rule plus condoms for anal have kept me neg.

  • I’m so surprised to be seeing this one here. It is such a coincidence because I am on this treatment right now, I have about 9 days left. I have to say one thing: If there is anything that has given me a healthy respect of HIV it has been taking these medications. I am taking Combivir. The side effects are significant and effect everything from my appetite, to my heart rate, to my body fat… Seriously guys, taking HIV meds is not a walk in the park. I’ve have many friends who take these drugs and I have a new found respect for what it takes to be on this stuff for a lifetime. You gotta be tough to live with this and I’m so grateful I happen to know about PEP so that I could go to my Dr after a lapse in judgement (I used ecstasy and got all crazy, took three loads from three different guys over a 24 hour period – the status of one of the guys was “unknown”).

    Please take this seriously guys, I want all of us to be healthy for our time in this incarnation.

  • i made an unwise decision by having unprotected sex with someone, but at the time i didnt know. I had sex with him in april and the two HIV test i took in july and november came back negative. Ive learned my lesson but im still worrying.

  • Patrick – if you are not HIV+ the medications will are not yet available for prevention. They have not been approved by the FDA for use as prevention yet.

    Part of the controversy over PrEP is regarding access to medications. There are thousands of HIV-Positive people here in the US (and many more in other countries) that do not have the medications they need to treat their illness, knowing this, there are those that believe that giving the medications to healthy people so they can have unprotected sex is not something that should be done.

    PozDude – you are correct, that was the conclusion of the study “transmission risk declines towards zero with falling sperm viral load.” …and there is other important information:

    If this is a strategy you are depending on to protect your partners, it is extremely important that you stay on your meds and test for STDs/infections regularly:

    After a few days or weeks of discontinuation of antiretroviral therapy, plasma viral load rises rapidly. There is at least one case report of transmission during this rebound.

    In patients not on treatment, STIs such as urethritis or genital ulcer disease increase the genital viral load; it falls again after the STI is treated.

    In a patient with urethritis, sperm viral load can rise slightly even while the patient is receiving effective treatment. This rise is small, however, much smaller that the rise observed in patients not on treatment

  • @Overit It’s not as simple as saying we have cell phones so why can’t we cure the disease? We still have cancer and diabetes as well so keep that in mind. It’s an insult to the dedicated science researchers who have come up with all the treatments we have today to say the scientific community has done nothing.

    @Sensibility I appreciate your well-thought-out and reasoned reply, though I take some issue with a few of your points. The statement you make about “the meds are not the end of the world” is accurate, but potentially misleading, because this kind of thinking also can lead people to engage in more risky behavior. The long term effects of the meds are not known, and won’t be for another 50 years. Managing a chronic disease is doable, but it’s no cakewalk. Just ask any Type I diabetic.

    The two bullets about “you can love and have sex with someone that is [the opposite serostatus] without fear” – wow, that’s quite a statement, and it’s a very personal choice. For many of us who are older and lived through the early 80s and early 90s as adults and are still HIV-negative it can be very difficult to change behaviors learned when it was a much scarier time. Maybe that’s not fair or “realistic” but there you have it – everyone should respect another person’s choice to have sex with whom they choose to – and choose not to. Sometimes HIV-negative guys can feel stigmatized too, by monikers like “poz-phobic” etc.

    @blog thanks for posting this story.

  • I have been HIV+ since July. I have always had unprotected sex (mostly as a top) since I was 20 (I am now 28). I was responsible and getting tested every 3 months. Since becoming poz I have NOT been taking medication and have not had any health problems or illness. Other than seasonal allergies (cedar pollen which is pretty horrible in Texas) nothing has gotten me sick. My doctor recommends meds but my CD4 and V Load counts are good. I am taking care of my body by exercising many times a week and eating healthy. I have quit smoking and cut back on alcohol significantly. This is just common sense, if you take care of your body you can live a long healthy life and be HIV positive and not have to go near medication.

    In this western society we live in, everyone thinks the best shortcut to wellness is by popping pills. That’s totally backwards. We are becoming slaves to the corporations and pharmaceutical giants and ignoring what our bodies really need – exercise and healthy diet. Natural detoxification is the path to a healthy HIV positive life.

  • It is nice that this has become available. It may save some people the struggle of taking HIV medications, the financial difficulties, and all the other ills associated with the disease. As far as safe sex goes, I have been positive for 20 years. Have had a very active sexual life and have infected no one. Have had a partner in an open relationship for the past 15 years. He remains negative. So all these people who say they got it from oral, anal rubbing, or other low risk transmissions perhaps uniformed of the additional risk factors that may be included that cause HIV infections. My partner/ partners have been performing oral on me for over 15 years, they make certain they do not have any open mouth sores. All of my partners prefer to penetrate me without a condom. They make certain they do not have any open sores on their penis. They all remain negative. If someone is rubbing their cock around on your anus after cumming and you have other open sores in that area that may have been the entry point. The fact is that there MUST be HIV active in the semen or blood and it MUST have a point of entry into the blood stream. And of course as long as I remain undetectable I have allowed a wee bit more risk such as rubbing my cock in the crack of someones anus. However my partners are always informed and understand that if we play safe, it can be just that SAFE. Often I hear these comments about transmission occurring while only having safe sex, yet I had seen them in action at a public place having less then safe sex with partners they do not even know, then they are ashamed to admit they had unsafe anal sex, used intravenous drugs, or other high risks. This only adds to the myths. Keep it real and factual. It is quite possible to play safely. Everyone should treat every partner as if they have HIV until they are certain they are in a monogamous relationship with just one partner if they choose. Hopefully I have added some light on this. Enjoy, be safe, and learn completely what safe really means. Knowing how to where a condom is just one small part of it.

  • i find it funny that there’s a supposed “cure” to irresponsibility and stupidity. wish i had that alternative when my ex bf decided it’d be fun to POZ my ass. but i have to live with never knowing exactly when i got his nice present. good luck to all of you who think they can tell the exact date and time they got it…and rushed to the hospital to expose yourself as a slut and list your last 10 years of sexual activity if you want the drug no doubt also. sorry if i seem bitter here, but there’d be a cure already if the drug companies werent making 1400.oo per MONTH of my pills. just me, yeah. what about the 50 million other americans alone that have this and deal with it daily to make some pharmacutical company rich.

  • Thank you Stephan for pointing out the obvious; there are HIV positive people all over the country who are unable to access medications at this time and are, literally, in fear for their life. In Florida alone, there are currently over 2,500 people on a waiting list who are caught up in a budget conundrum and are, I’m sure, feeling helpless and lost. I ask you all, How fair is it that they can’t access to medications to save their life, yet someone who loves to go to a bathhouse and get ‘barebacked’ every weekend can get a Truvada prescription and keep on fucking?!

    @JK – Your defense of the dedicated scientific community is spot-on! This is but a mere baby step in the grand scheme of things and, though these things take time and money, a vaccine will be found.

    Educate yourselves about vaccine research and get involved.

  • who, where, when?? HIV pos and scared to death. I am taking meds for 2 months now. Feeling much better but life isn’t the same. Be safe enjoy but there is always a risk. I have no clue of who, where, when it happen.

  • Responsible sex is what really reduce the alarming rates of hiv cases. Safe sex with the use of available precautionary resources plus the attitudes always helps in this rampant pandemic. To educate and to let everyone knows of HIV and it’s underlying facts always helps to fathom fear of transmissions. Thanks for this post. An eye opener.

  • I am pretty new to the gay scene and have a couple questions:

    1. If I have unprotected sex with an HIV-Positive male, am I at a significantly smaller risk of contracting the disease as a top versus a bottom?

    2. If I choose to ejaculate inside the anus of my HIV-Positive partner, does that increase my risk of contracting HIV?

  • This forum was truly needed and even if we disagree, knowing the option PEP and PREP offer to us is wonderful. I feel if we truly want to slow down the spread of HIV/AIDS we have to educate, educate and educate ourselves, friends and family. We need to get to the root of the problem. PEP and PREP is great but it can get ugly quickly. As soon as people begin saying I can pop the magic pill to prevent from getting the virus; we will be in trouble. I’m sorry to say, but A4A, men4now; BGC etc… play a major role in the spreading of HIV/AIDS and other STDs. These sex sites are part of the root problem in spreading the virus. I’m not bashing these sites because as a single gay male, I benefit from them in more ways than the one ya’ll thinking about. I just think more can be done as far as having more forums like this, more advertisement about protection and definitely more can be done to curb the stigma associated with people living with HIV/AIDS. When those of us living with HIV/AIDS see things aren’t all that bad, I feel they are more likely to share their status with their partners and be truthful about the status posted on their profile.

  • Why no mention of very dangerous side effects from HIV medication such as liver damage and damage to other vital organs? Sure PREP might (key word is might) reduce HIV but were going to have a whole generation damaged from the medications and if you add in the fact many people are going to be mixing dangerous drugs with alcoholic and other drugs–OH BOY!

    I can see it now a whole new market for drugs to fix the damage the PREP drugs have done.

    The ONLY way HIV is going to be reduced is for people to learn self love and to take responsibility for their own actions.

    The ones promoting HIV prevention also have to get real with their message and stop treating this disease like it is diabetes. HIV is an incurable disease that has caused many people to die from AIDS/HIV related illnesses.

    I get so damned angry and sick at my stomach every time I see this fact glossed over by some fool who wants to convince others that HIV is a “manageable” illness or “not that big of a deal.” Those promoting safer sex do it, those promoting HIV medications do it!

    Instead of being truthful about HIV it has been turned into some sort of sick circus of political correctness.

    I get even more sick when I see Gay men who think Drs and the medical / pharmaceutical industry can fix everything.

    The truth is Drs can fix/cure/treat far less than you think, and ultimately much of what most Gay men are running to the Dr for could have been prevented if they had shown a bit of self respect and self restraint.

    Wake up and take responsibility for yourself because no one else is going to do it for you!

  • I wish I had know about the 72 hours for PEP. I had unprotected relations with a “married to a woman guy” and within hours of it I received an “anonymous” e-mail telling me the guy was positive. I had no clue what to do other than look at myself in the mirror and begin to worry and own up to my actions if I ended up contracting HIV and being diagnosed with it in the months to follow. Within about 30 days from exposure I seroconverted with the chills and all. Had I known about the PEP I would have immediately done it whether it was covered by insurance or not. I have for the rest of my life to take medication on a daily basis and every three months get my liver and various levels tested to see if the current drug (Atripla) is still working. It was stupid of me to contract this for a few minutes of sex which wasn’t even all that. I should have listened to my partner of 6 years who told me you always glove up with a hookup so that you can truly enjoy it the “natural” way with the one you love. He’s 15 years younger than me and oh so wise.

  • Answer to Johns ? The bottom is always at more risk, and I do not believe that the top cumming inside the bottom increases the risk to the top. However I have seen reports to the contrary but my partner has never worn a condom and he remains HIV negative after 15 years and countless times. However there are other factors that do come into play here, uncircumcised is reported to increase the infection for tops because the extra skin may tear, if you have any sores on your penis you are also at increased risk. If you are a top and are having sex with HIV/POZ person or unknown person be sure to check to make sure you have no sores(like from masturbation without lube). And be sure to use plenty of lube…. this helps to keep the skin from breaking open. I wished we would get back to carefully describing the increases in risk with the various types of sex.

  • Nothing is more frustrating than misinformation. Jason’s post is a great example of this.

    For most people who test positive today, HIV is an easier disease to manage than diabetes. The side effects that people keep throwing out there are not experienced by most people using newer medications. If a person is having a reaction in their liver or other organs, it happens right away and discrepancies would show up on the first round of labs after starting treatment. A doctor who knows what they are doing would immediately take the patient off of that medication and put them on another one that attacks the virus at a different point in its life cycle.

    When I tested positive, my viral load was moderate. I started treatment and my viral load dropped 95% in FOUR days. In under three weeks, it was undetectable. No side effects. One pill a day in the morning (I also take vitamins, fish oil and probiotics). Everything is working as it should. As long as I continue treatment and take care of myself, there’s no reason why I won’t have a normal life expectancy- a conclusion I draw based on several studies.

    Being HIV+ is a far cry from the end of the world, and it’s not nearly as dramatic or difficult as a lot of people seem to think. Yeah, a lot of people have died from AIDS. A lot of people have also died from scarlet fever and yellow fever. AIDS-related deaths are way down even though the number of people infected continues to rise. To act as if there have been no advances in treatment or assume that everyone deals with extreme side effects isn’t honest.

    The problem is that people don’t get tested. Test, treat, and the spread of this disease will disappear. Prevention programs just don’t work that well. Why? Because sex feels 500% better without a condom, and apparently the hormones related to pleasure are stronger than those related to fear.

  • Jim, for you and others who come on here saying HIV is easy to manage, I think that is just plain irresponsible and would be as stupid as me saying cancer is easy to manage.

    There is a HUGE problem with people not getting tested for HIV and other STDS but I think people who try to make HIV sound like some sort of walk in the park are equally part of the problem. It sends the message that HIV is not a big deal and it does not matter if one gets infected.

    You seem to want to make it sound as if no one is dying any more of of HIV related illnesses and that the medications are like taking a daily vitamin.

    Test and treat simply do not work by themselves! There has to be a strong prevention component else HIV will not go away. Education and self respect go a long way in keeping people healthy.

    One has to take pause when they read a message such as yours and ask what is your agenda!?!?!

    The fact that you are an advocate of testing and treating but scoff rather harshly at prevention should show everyone that there are sick people in the world who think this disease is not a big deal, and that there are some (possibly even you Jim) who want to keep new infections going.

  • Jason, you are so correct, after being HIV poz 20 years now I know the trials of taking drugs and even the trials before the drugs when we just watched our brothers die. The drugs are only so tolerable, and after so many failed regimens some people run out of options and out of time as well. I have always said that prevention is paramount, and along with that testing is a huge part of prevention, test people, inform them & most stop the spread immediately. Awareness & Education are equally important as well. Real factual education explaining harm reduction thru abstinence education is the proper way. After it was decided to return to mostly abstinence only education it has become apparent to me that the # of infections have been increasing in our youth particularly. And there will always be the cases that are just not likely to be prevented because self esteem must be learned at an early age and often homosexual men have been bullied and beaten down in society where they lack these needed qualities. Also factor in the ones that just simply refuse to heed warning of any kind and do only as they choose and there will be some occurrences of new infections for some time to come. Then factor in the 8 year period of many children not getting a harm reduction education or true knowledge of how HIV is spread and you will have an increase in HIV transmissions going on totally unaware and this seems to still be the driving factor in most new infections that I have been involved in. By time they had enough information to realize that they had actually been at GREAT risk and got a test they had been infected already and in many cases for many years infecting other partners. So we need to get back to doing what we were doing in the Clinton years and we will see this disease begin to decrease in new infections again. AIDS is never such a cut and dry case but in one of the earlier posts I read a comment about finding the cure… One day this will end all our discussions about HIV except as an historical lesson in which I hope we are better able to put aside our discriminations and focus on science based facts, and statistical calculations rather than political or religious views that can prevent this sort of pandemic from ever occurring at such a large rate… We all know had the warning being announced more prominently and effectively in the beginning this would be a small problem affecting much less people… Be sure and read Vito Russo’s Speech given at Albany NY and Washington D.C. titled “Why we fight!! Keep up the dialogue everyone and keep up the good fight until we win the war over this disease!!

  • Terry, I am glad someone sees that I am not over reacting. You are 100% right when you say drugs are only so tolerable and that prevention is paramount.

    During the Clinton years I saw many people I knew personally die, but what I saw was people I knew who were not infected going and getting tested, and I saw them actually have a reasonable fear of being infected and thus doing what the could to protect themselves.

    What I am seeing now is something that very few want to talk honestly about. There seems to be this new idea among Gay men both older and younger that HIV is somehow no longer killing people and that becoming infected is something really does not matter you can pop a few pills or even take no medication at all and somehow be perfectly fine.

    I feel the “magical” thinking that too many people have about HIV being easier to deal with than diabetes is not only causing untold misery to those who buy into the lies, I feel it spits in the face of every person who is living with HIV or has died from a HIV related illness.

    The speech you mentioned is a wonderful place to start if people want to start getting real about this.

    I would also recommend checking out “The Gift” which is a harsh documentary about people foolish enough to want HIV, and I would encourage people who think HIV is not a big deal to talk with those who have lost loved ones to HIV related illnesses.

    As you said, self love and respect are best learned at a young age, but I feel it is never too late to fight back against abuse and to learn self respect and self love.

    Such self love and self respect is missing from the gay community as a whole, and it is sad because not only is it a powerful tool in HIV/STD prevention, I think it is a powerful tool in the fight for equality and over all satisfaction in life.

  • I’m not scoffing at prevention, but if it worked for my peer group then we wouldn’t see increased rates of HIV infection among 20 to 30 year-olds. We’ve been inundated with safe-sex messages our entire lives. There definitely hasn’t been a lack of effort when it comes to prevention, but the message obviously isn’t working and HIV rates among younger people continue to increase.

    Why do I advocate testing and treating? Because the people spreading HIV are the 44% who aren’t even aware that they are infected. If these people all started treatment, we could reduce new HIV infections by 90% in a matter of months. Jason, my agenda is to stop the spread of HIV in a way that works.

    There is definitely a generational disconnect going on here, and I don’t think that you can take the experiences of a 20-year survivor and compare them to what a 20-year-old who is newly diagnosed today would face. Twenty years ago, they were prescribing AZT in doses that were 5 times higher than what people take today. Of course there were higher rates of toxicity! They didn’t know nearly as much about the disease.

    I do not want to sound disrespectful in any way, but I feel at times that there are some people who have been through hell and dealt with the ravages of this disease or seen friends and loved ones die who really hate the idea that if a person is diagnosed early enough and starts treatment when appropriate and sticks to it, that HIV doesn’t have to be a life-changing or defining event. I lost an uncle to AIDS in the early 90′s. My experience has been nothing like his.

    A lot of my peers are frightened of getting tested and dealing with the results. I know that I was. This idea that my life was going to change overnight, that I’d have to deal with horrible side effects from medication, that somehow having HIV would define me- this would scare anyone. We see men of another generation who have really had so much of their lives defined by this disease- and most haven’t had a choice in the matter.

    I finally got tested and dealt with the consequences. I haven’t missed a single day of work because of HIV. No one knows except for my partner, doctor and pharmacist. And yep- one pill a day, no side effects.

    Is it irresponsible for me to share what my experience has been with HIV? I don’t think so, because if I had known that it would have such a small impact on my life I wouldn’t have been so irrational about getting tested in the first place. I’m sure that any doctor specializing in HIV treatment would tell you that every patient has a different experience, but by focusing on worse-case scenarios that are unlikely for a newly-diagnosed person in 2011, we’re probably causing more new infections than we are preventing.

  • Jim, Yay for you for not having side effects on your medication, and for tolerating it.

    Maybe you can tell my friend who just had to quit his job because the medications had horrific side effects( bowel issues, weakness, liver enlargement, and vision problems) how wonderful and side effect free the newer medications are!

    Is it irresponsible for you to share what your experience has been with HIV?

    I would agree that it is not, however what I have a problem with is you and some others downplaying HIV like it is some sort of walk in the park.

    HIV is a serious illness, and the medications are not as well tolerated as you would like people to think. Some tolerate them just fine, others have such a bad reaction that they simply can’t take them.

    I see the fiction you are spewing as dangerous and as I have stated there are sick people out there who want to keep new infections going by downplaying HIV. I seriously hope you are not one of those people.

    Prevention works, but only if people don’t scoff at it and actually use it! This thinking that testing and treatment works without putting a strong focus on prevention is just plain silly.

    As for fear of being tested, I totally get that, however I am not one who is going to say you should not be afraid of getting tested, you should be tested on a regular basis and know your status. A certain amount of fear when getting tested is normal and healthy.

    Seriously, if being afraid is what it takes to make a person practice safer sex, or make other lifestyle changes, I say be afraid!

    I think it is healthy to understand there are consequences to our actions, and that fear can be a great motivator especially when it comes to self preservation.

  • I’m not downplaying HIV at all. I wish that you and some others would actually listen to what medical professionals have to say about this. They’re the ones comparing HIV to diabetes, who claim that life expectancy is the same, and who say that most of their patients starting treatment now handle it quite well.

    That’s reality today. I don’t think that my experience with this is particularly unique.

    Your friend should find a new doctor. All of that would have been prevented if his doctor had monitored his liver function correctly and pulled him off of that particular medication at the first sign of a problem. All of his symptoms are tied into irregularities with liver function.

  • Jim, you are down playing it!!! The more you speak I think you have a rather sinister agenda or that you are delusional.

    How dare you try to make it sound as if my friend is an anomaly because they are not tolerating HIV medication!

    I know of several people all young and all seeing excellent Drs who have had their lives turned upside down by HIV and the medications. As one person put it drugs are only so tolerable…

    The truth that you don’t want to hear is that not everyone does well on medication, and ultimately HIV is a serious illness that might shorten and devastate the quality of a person’s life.

    Infection rates are increasing because no one wants to be real, they instead want to spew this politically correct lie that everyone is living happily ever after with HIV.

  • No shit, Jason. Of course not EVERYONE does well on medication. MOST people today do. Not EVERYONE is living happily ever after with HIV, but if you think that the vast majority of HIV+ people are living difficult, painful, tragic lives dictated by a virus then you have no clue what you are talking about.

    I have no sinister agenda (though you seem a little paranoid)! All I did was state my own personal experience and scientific data. Your anecdotal evidence is great, but you definitely have a viewpoint outside of the medical mainstream that you seem so personally invested in that you’re never going to consider any factual information.

    The truth that YOU don’t want to hear is that there are a lot of people out there with HIV who never talk about it. You’d never know it because a lot of people just don’t feel like they need to share their medical history with everyone else. They live lives just like everyone else.

    I don’t know what your own personal issues are, but you’ve done a great job at twisting my words around and trying to make it look as though I want HIV to spread, which is the opposite of what I hope happens.

  • Enough already!

    When someone starts their discourse with “I don’t want to sound disrespectful, but” well, you know….
    When someone starts their rebuttal with “I’m not downplaying, but” well, you know….

    A prescription for Truvada costs approximately $1400 per month.

    Offering this to the MSM community is a step in the right direction to making sure that everyone knows their status. I’m just so happy to know that most doctors are ethically sensible and, though they won’t give you the “magic-pill” prescription that you came in for, they will certainly make sure that you get an HIV test!

  • Sorry, my last post was incomplete. A prescription for PrEP will be very expensive and I can almost guarantee that there is no insurance company out there that will approve this, essentially elective, course of treatment. But, as I said, it will get people into their doctor’s offices where they will then be offered an HIV test.

  • Jim, I don’t know what your intentions are, but I do know you spew venom towards those who disagree with the message that HIV is a walk in the park.

    As for twisting your words, no I am not doing that, you are the one who said what you said and if you don’t like my response oh well!

    I don’t have any personal issues other than I see more and more young 20 somethings and even some older adults (who should know better) buying in to the BS that HIV no longer kills, the medications are tolerable, and the need to be careful and use common sense has gone away because of newer drugs. The wrong message is being sent and it is going to harm a great many people.

    Jim, you can try to treat me like a child all you want and insult my opinion that there needs to be a strong focus on prevention as being outside the mainstream, but you dear are the one who the one running around talking about how simple it is living with HIV and how the focus should be on testing and treatment not prevention.

    As for people not talking about their HIV status, that is you trying to confuse the argument. I will reply to you and say I am all for medical privacy unless it is with intimate relationships.

  • Jason and Jim, calm down or i will delete all your comments !

  • RichBaer, I am one who thinks HIV test should be offered at almost every turn and I think there needs to be a lot of pressure put on people to do so. I liked your post.

    Blog moderator, sorry if my post come across a bit strong, however I am not going to be calm or quiet when people try to make HIV sound like a bed of roses.

    Infection rates are up, and the politically correct thing is to pretend no one is dying of HIV any more, and the medication is as safe as candy.

  • I’m going to back Jason on this arguement, hiv is a big deal, taking the consequenses of infection lightly is stupid, and that Jim is rah-rahing some kind of new attitude of “shucks, oh well”. I think the biggest contributors to this attitude are the new producers of porn. Everything anymore is bareback this, bareback that. I’m no prude, I get a thrill from watching a good sloppy facial (alright, more turned on if the guy’s actually eating the load), but raw up the ass, I just don’t get it. Yes, I’m aware of the risk of oral transmission, or getting it in the eye, but the odds of anal tissue tearing during intercourse is almost a certainty (unless the bottom’s a fister and it feels like a toothpick penetrating the Grand Canyon, yikes) My gawd, if all it takes is a little effort to roll on a condom versus a lifetime regimine of organ-killing drugs, I’ll pick the Trojans. Seriously, there should be laws against disseminating raw porn, it sends the wrong message. Two points you may want to consider. One, hiv is a highly mutatable virus, just cuz your meds work today, that doesn’t mean a new nastier version isn’t brewing out there for your next poz party. Two, I suspect Jim has company paid health insurance and is under this misconception that he’ll always have that benefit available. I was riding pretty high in my life ten years ago, self-employed, bonafide millionaire, properties, highly divested investments and then one on-going lawsuit later and poof!, all gone. Now I’m working $15/hr jobs, no benefits, and recurring health issues generated primarily from stress of arbitration never seeing the light of day. No insurance company will touch me at any price (I lost my original health coverage because I was financially exhausted) and if you think there’s a government safety-net out there waiting for you, think again. I couldn’t come close to paying $1400/mo to pay for inhibitors. My medical retirement is coming down to a long drop off a tall cliff and I think that will be the reality for most americans working today. Can you imagine politicians trying to press medical care to a straight taxpaying base for seemingly irresponsible sexual activity, when most people struggle to finance their own health care? I think the saddest thing I’ve ever read was a profile of an 18yo kid who proudly converted voluntarily ….to get it over with, I’m assuming. I find it akin to some young jihadist being strapped with a bomb at the bequest of older, more experienced muslims (who seem to never blow themselves apart for their beliefs) for some kind of twisted belief system. And the band plays on.

  • Jason, i agree, we cannot take this as a bed of roses, that’s for sure.
    And it’s true that many people now think medication is easy and safe, but it’s not !
    My message to all is “use condom” !

  • Rick, I am glad you wrote your comments. I am seeing more and more of the people not thinking HIV is a big deal and they need to read your post and others like them!

    I agree with the blog moderator to use a condom! I would also go on to say, don’t just jump in bed with a stranger, respect yourself and get to know a person. Sometimes that can be more fun than actual sex!

    What is scaring me in all of this is more and more poz people are the ones giving the education to negative people that HIV is not a big deal.

    Rick, I feel sick thinking about the 18 year old kid who willingly got infected. I wonder how many people put it in his head that HIV was not a death sentence, and that HIV was easier to live with than diabetes.

    I know several people who I am sure are going to end up HIV+ in the near future and it is because of the HIV is a cakewalk and all the meds are great BS coming from people who know better!

    The worst part is some of these people are 30 plus, and should know better!

    I don’t get how people who have lived with HIV can downplay the severity of this disease. Perhaps they are in denial? Can anyone explain this because I don’t understand.

    All of us who have lost friends to HIV related illnesses, and know the devastation that HIV causes need to our part to get the real truth out there. If we don’t shame on us!

  • This was all very informative.

    It has been my life experience, to take from everyone’s experience. I am only human enough to say, “That I am not perfect, so I will not understand everything…who will?”
    However I can say that each of you is important to me because I want to be educated, no matter what kind of human that I am. It is important for me to feel close to a family who cares, a family who understands, a family in which will give me information…like a parent to his child or a child learning sharing something with their parent. Everything is important no matter how big or small, no matter the way one may or may not see it….for everyone is different.

    Being a person who is not positive, I share my life with all people…because it takes us all. Everything can happen to us at any time and so with time…we just must live it as it is present itself to us. You all humble me with positive information, comments or frustrations…it really helps my life and heart.

    Very grateful you have shared what you have, it does help me..as I am sure it will help others, as well as each other.

    Thank you, so much !

    Most Sincere Regards,


  • Well when HIV is compared to diabetes I think of my friend laying in the hospital right now with diabetes. He has had toes chopped off so far. He takes insulin injections everyday. His pill regimen is more complicated then my HIV meds are. Personally I know a few people who are tolerating the meds quite well myself included at the moment. But I also know countless more that are not tolerating the meds well at all. The expense is astronomical and I know that resources to pay for these are drying up. I also know that as I have stated before that prevention is paramount. Testing and diagnosis is an intricate part of prevention to stop spread from those who do not know. Back to the issue at hand pep and prep will stop some of these infections from becoming a life long illness. It is a good thing if we can treat this right away and stop it. But meanwhile less all be careful. Lets all work toward the stopping of this disease.

  • Sensibility puhleeeez. They’re stigmatizing themselves by being careless, irresponsible filth mongers with no common sense -That’s why they have HIV

  • @Sensibility, it’s no different than 40% of the soldiers during the Civil War that had some kind of STD and many died. Back then diseases that we have a cure for now were fatal. They knew the risks, but didn’t care. From what I understand they had condoms back then, but they didn’t want to use them to fuck all the whores they frequented

  • Only thing i have to say , is i am Poz ,, but do you really think drug companies want to truly find the cure, when they make so much more money by not finding the cure , remember there all in it for the money, do they truly care ,

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