23 Jan 2013

Health : Using HIV Meds To Stay HIV-Free

Category: Health

I’ve watched very closely the responses that came from my last posting regarding when to tell someone their HIV-positive status.  For the most part, it seems that the topic is one that still remains relevant and controversial.  The majority of the responses, as I suspected they would be, fell firmly on the side of complete disclosure from the start.  And as I also knew would happen, a couple people either misread or ignored the point of the posting and came back with reactions that were judgmental or accusatory and with no added value to the discussion.  It’s obvious that our society, or community, or whatever demographic label we choose to describe ourselves as, we men who are sexually attracted to men need to be continuously discussing and sharing valuable and pertinent information regarding not only HIV but all sorts of issues that affect us as a group.  I believe we still need to rely on ourselves for information, protection, and in many parts of the world, our survival.  For now, however, I’m going to remain on the topic of HIV. I am also going to keep it simple. The main reason for simplicity is because so many men are not talking about it.  I don’t know exactly why this is, perhaps the subject seems passé, but I have a hunch that the real reason is because people just don’t know basic facts regarding HIV, transmission, and safety.  For this I blame the governments, I blame schools, I blame morally conservative politicians and religious leaders that refuse to believe anything other than what has been handed down from 1000+ year old books.  But mostly I blame us, the people that have been affected a great deal for not keeping HIV in the forefront of accurate discussion and awareness. It can get boring, I know, but the discussion must continue.

Let me start by talking about what being HIV-positive and undetectable means.  Essentially, undetectable simply means that the virus itself is in such low quantities in the blood that the current technology at a laboratory is unable to get an accurate count from the small sample of blood analyzed.  It does not mean that a person who is undetectable is HIV-free; it just means that the virus is not replicating and is being suppressed.  Such a situation really only occurs when an HIV infected person is taking medication faithfully.  Undetectable status has become the norm for men who are infected and on medication. Studies have been coming out recently that also indicate that someone who is undetectable is also less likely to pass the virus onto someone who is not infected.  But less likely is not 100% guaranteed to mean it can’t happen.  It still can. Doctors or lab technicians may not be able to count all of the virus levels (well they can, but it costs more than insurance companies want to pay), but the little buggers are still there somewhere, just in a very small quantity. They still exist.  They can still infect.  Protection still needs to be used.

That’s a very simple explanation I know, but it basically covers the gist of it. My apologies to those of you that are much more aware and educated on the subject, and I trust you will continue to add to the discussion supportively.  Unfortunately it seems many men are not as experienced or knowledgeable and the discussion needs to be understandable to everyone.

Up until the last year, the only absolutely certain protection we had against contracting HIV was to abstain from sex entirely.  Well, that’s still the only 100% safe option, but for the vast majority of us, it just won’t do.  The second option was using really safe (and really boring) sexual play such as mutual masturbation.  Finally, using a condom during intercourse gave the highest percentage of safety we could get…maybe in the 80-something percent ranges, but that tracking is difficult to verify.  People may not always use condoms or don’t always report not using them.  Plus, sometimes there is condom breakage or other defects.  So our best options to remain sexually active and healthy were not having sex, using condoms, or taking medication if we were HIV-positive (and using a condom).  Again, up until last year…

Last year, the U.S. Food and Drug Administration approved the use of an already existing HIV medication on the market called Truvada for use by HIV-negative people to help keep from becoming infected.  It is being re-packaged and renamed PrEP for Pre-Exposure Prophylaxis.  Studies have shown that the medication can stop the virus from getting a foothold in the body’s system and therefore not infecting the user.  The studies are showing that infection blockage was being increased up to the high 90 percent ranges.  Now here comes the catch:  it was studied in conjunction with use with a condom. Ethically, the people doing the studies could not just hand out pills and tell people to go fuck and let’s see if you become positive or not.  The control groups were condom-only users and compared with the people using the Truvada/PrEP in addition to the condom.

Unfortunately, I’m concerned that the studies with a condom are being lost in the hype of the additional protection the medication provides.  I’m reading accounts from one blogger in particular on another sex site write about how he’s using himself as a guinea pig by only taking the medication and not using anything else just so he can get fucked bareback the way he prefers.  Needless to say, I’m skeptical.  I’m skeptical about precautions not being fully explained to or understood by people wanting more protection from HIV.  I’m skeptical that people can afford this very expensive medication (in the $2000 range for one month’s supply).  I’m skeptical that people will forget to take the medication daily. It MUST be taken every day in order to be effective.  Finally, I’m skeptical that it will add a false sense of security from other god-only-knows-what infections such as hepatitis, syphilis, or other STIs like gonorrhea or chlamydia; diseases the drug has no effect against. Remember herpes? It’s still out there.

Please don’t get me wrong. I think this newest tool to combat HIV is worthwhile. I want HIV dead, crushed, completely obliterated from the human population.  But use PrEP correctly with the full facts. For a quick rundown, check out:  http://www.cdc.gov/hiv/prep/pdf/PrEPfactsheet.pdf.  And always, always remain vigilant.  We really can get rid of HIV in our lifetime if we stay informed.

David Beck

 

 

61 comments for Health : Using HIV Meds To Stay HIV-Free

  • Wow, great info. Thanks for sharing. Though I think its extremely important to keep this topic in the front of public consciousness I think people are sick of hearing about HIV. Especially for those of us that live in smaller cities and towns. HIV is a “big city problem” If you have a large gay community then one would expect this to be an issue but if you live where you rarely even encounter another LGBT person it doesn’t feel like a big concern.
    What’s worse is that AIDS has been in the public eye since I hit puberty. Because of this, Sex has always been associated with the possibility of death. I stayed a virgin till I was 21. I only lost it then cause I was fed up with being gay but never having actually touched another guy! I use condoms EVERY time I have sex but I’ll be honest even though I’d never want to be positive if it happened it would almost be a relief. Because then I could say “Well it finally happened. At least now I can stop fucking worrying about catching it and just enjoy having sex.”
    If we want to keep the dialogue open and fresh I think we need to stop treating infection as an inevitability, stop glorifying unsafe and degrading sex practices, get the adult industry on board with portraying healthy relationships and sexual situations. Myself and I think many other people learned about sex thru porn and “Bareback cumdump slut boys” probably didn’t teach me or anyone else any healthy sexual practices. LOL

  • I like the information that you provided and the need to get it out there and discussed. However, your beginning rant was unnecessary.

  • The best prevention is to use condoms at all time,,,, no matter what.

  • My question is, are gay men going to start using this as their version of plan b, for women? Lol

  • discusion is knowledge lets all talk about sex hiv and its affects on gay men and society in general know your status get tested reguarly

  • Thank you for bringing this issue up again. The gay community is grossly uninformed on HIV and we need to work to get rid of the stigma

  • Thanks David. There is even more hopeful news coming…

  • A descent read but that’s it.

  • I’m curious to know where this blog is located.

  • You state “people just don’t know basic facts regarding HIV, transmission, and safety.” Bullshit. Anyone who has come of age in the past 20 years knows damn well how HIV is transmitted and knows full well that using condoms every time is still the best way for sexually active people to prevent HIV transmission. Put the blame for continued HIV transmission squarely where it belongs: on the backs of the crowd promoting unsafe sex. The continued glorification of “bareback” sex as “hotter” or “more natural” combined with the derision scoffed at those who promote safer sex (“condom queen” anyone?)have succeeded in creating a general attitude that encourages men to not speak up and insist upon safer sex procedures while painting unsafe practices as more exciting and more real and sexy. Just Google barebackrt.com or rawtop.com or any number of porn studios and it is clear that there is a concerted effort afoot to discourage safer sex and it isn’t the government, schools, or morally conservative politicians and religious leaders who are behind it.

  • Did I hear Aja right? That Hiv is only a big city problem? That’s downright scary, I live in a very isolated small city of 40,000, it’s 180 miles to the nearest gay bar, and I know of at least half a dozen hiv poz guys living here. Hell there’s three ex-porn stars living here. I think a lot of small town guys that run off to the bigger cities and end up being infected fall into the idea of returning home away from the lifestyle and temptations. The problem with that thinking is their libidos come back with them. They find that being honest and forthright with their status is a surefire way of NOT finding a date (or an unsatisfying pool from which to choose) when they succumb to the horniness and start bending or omitting the truth. To think Hiv is only a big city problem is insane. Gays are also very mobile compared to the population at large, we take jobs that keep us from home for weeks at a time (we’re not family men and can be away from home) or we’re highly successful and get the hell out of Dodge as often as possible. I was a non-stop whore in the 80’s, I spent more time chasing cock in West Hollywood than I ever did here. Every time I came home, I’d think to myself “this is it, this is the time I went too far” and would wait anxiously for the hiv test results. Fortunately, I played relatively safe, condoms for fucking and rarely taking a load in the mouth, and somehow survived the nightmare. Now I just get angry watching these kids fuck bareback with other “hiv neg” guys, I mean how stupid can one get? It’s simply the matter of a guy lying to get a piece of ass and we all know that’s never happened in the history of mankind. One mutation, one disruption in drug supply, one civil event that disrupts transportation and the gay community is back to the horrors of the 1980’s. And this next time, I’m not so sure the mainstream society is going to be all that empathetic to our plight. It’s time that bareback pornography gets outlawed, it’s all this new generation sees and understands. Is Paul Morris dead yet?

  • Matieu,

    To begin with, David did an incredible job with this piece. So kudos to him!

    Secondly, in your attempt to give a backhanded compliment, you used the wrong word. You were aiming for “decent”; look up “descent”.

  • Very well thought out blog entry. It’s important that we
    understand HIV and how it is contracted and what to do to
    combat it. Also, aren’t there clinical trials studying the
    effectiveness of a HIV vaccine?

  • how about getting rid of anything goes in A4A and make you click a pledge. We as a people attack anyone that says you need to wear protection and you are spreading something that will mutate and outsmart medication.
    Our response (in general) Stay out of my business, its a choice.

    NO IT IS NOT. you are going to kill people potentially so this goes beyond a choice. The fact we know better and still just dont care enough to do what is right is disgusting. Bottom line is, do we care enough to not kill ourselves? We are doing to ourselves what some of you say the government is doing to or wishing do to us. We need to be better than this. We MUST be better than this.

  • Maybe just stop thinking that man is the all cure all! Gayness is not of God and it doesn’t matter whst the homos of the world think, say or do. Listen to God!

  • The drug has all ready proven effective to reduce the amount of virus in someone who is HIV+ this is the more import component of the debate; getting those who are positive on this medication. That is the greater sense of the two. It arrests the ability, while not entierly, of the HIV virus to be transmitted. That’s even more important then using it as a preventative. I am unsure why the costs are still but. I know Truvada is still under patent but is widely used as part of HIV treatment. The costs aren’t relevant. Which while we’re on the topic it’s roughly $1600 for a 39 day supply.

    It should very much be implemented for all gay men who identify as bottoms. It would very much be more cost effective then paying for long term treatment for as a positive person.

    The data on the trial runs of the NON-positive users, I feel, isn’t as important as data on how it arrests the disease, over-all. That data has been tested and backed up with actual use. We know from long term usage it does indeed do what it says on the tin to help HIV+ from being unable to spread the virus. Regardless of the studies on HIV- people.

    There is no data on the actual partners these men in the trial studies had. We can’t be certain any of them actually came into contact with anyone who was HIV+. Only those who had partners who were Poz do we know for sure were coming into contact with the virus. It’s a bit of a guessing game once the trails included single gay men out on the town as it were.

    All in all I think it’s brilliant and a step in the right direction. We have to take control of our health. We can’t be held hostage to the worry of getting tested every 6 months. It causes a lot of stress and has proven to lead people to become so called bug-chasers just to no longer have the fear of “when it will happen” that their test comes back positive. Nor can we be held hostage to the heterosexual norms (which I think are only based in sexual habits of straight women not the men).

  • I think the real reason bareback sex is becoming more popular again is because HIV is no longer a death sentence and condoms really make sex unenjoyable for alot of us. I too grew up in the era when AIDS was brand new and killing gay men left and right and was lectured to by older gay friends that I had to either abstain or use condoms and only have sex with a monogamous partner or else I could get AIDS and die. That made it all so scary and I only topped for most of my life and used condoms all the time. Then I began wanting to bottom more and more but frankly the condoms made it uncomfortable and I wanted to experience ALL of the sensations. This coincided with HIV becoming more controllable and treatable and my being exposed to more and more HIV positive guys who were healthy and wonderful, sexy people who I really liked. Then I fell in love with someone who turned out to be POZ and that really changed my view of things. I searched the internet for all the info I could and talked to other HIV positive guys and organizations for the health of POZ men and thier partners because I wanted to find a way to have sex with my boyfriend and still enjoy it. The reality was that the condoms became a barrier that we HAD to have between us and even if we were monogamous that couldn’t change or he could infect me even if he were on meds (although the risk in that case would be significantly lower if he was undetectable). This unfortunately made the other normal stressers of relationships bigger and we parted ways. We actually had a few instances where we were drunk and he fucked me bareback and once he even came in me and I bled and I was terrified for months that I had been infected, but I hadn’t. The point is that this whole thing changed my outlook on “safe” sex and its importance in my life. My partner who was HIV positive felt free to have unprotected sex with whomever was attracted to and enjoyed it and didn’t have to worry about getting infected but he was perfectly healthy. I spent my whole life living in fear and was unable to enjoy sex the way I really wanted to. After seeing that so personally, and already being middle aged, I decided it was time to let some walls down and try a different approach. I decided that risk was always present with gay sex anyway so why not take the bull by the horn and enjoy it my way. I started having unprotected sex with guys I felt were safe enough in their experiences and exposure to not have been infected with HIV. I decided that getting to know them and thier sexual habits and confronting them head on about thier HIV status was enough protection for me and that the point was not to sleep with tons of guys but find the one(s) that I felt safe with so that I could fully enjoy the experience with a very low risk factor. I have to say this was the best development in my sex life ever. I have less sex and less partners but I enjoy what I do get more than ever before. I have checked into Truvada as PReP and so far it is not an option because of the cost. I am hopeful that a more reliable and affordable vaccine is just aound the corner, it is such a shame that we have to live in fear of enjoying our own sexuality.

  • Good read. It should also be noted that Truvada has been shown to have negative renal (kidney) implications after long term use by African American males. Further, another good topic for this blog would be can love/companionship be found long term if one guy positive and one guy is negative? Somettimes guys are a really good fit on all levels and then the disclosure of HIV rears its ugl head & the union is dissolved. Again, thanks for the info.

  • Great follow up David from that blog posting. This was great info and glad that you classified what undetectable means.it is still disheartening that when you disclose to someone about being positive you become an outcast.i contacted my hiv from a woman YES,a woman.Evelyn being married for 13 years i never expected it.lesson for me none is safe from this.education is a very powerful tool, ignorance is blind.i have been undetectable court over 3 years now. I take atripla and it is not for the reason that i needed needs because of my count its because i love my partner and i choose to fer both of pour

  • Interesting article. There are a few realities here that we love to pretend don’t exist that will continue to be an issue for us and HIV stats with the gays. In my personal opinon, I dont think its just unprotected sex that is the issue, its the fact that many of us wanna fuck everyone in town, and twice on Sunday, UNPROTECTED. Everyone knows that this is going on but most of us pretend it doesnt exist. Why isnt there a push to get guy to streamline their number of partners. Pick one or two people,get together, make some adult guidelines for yourself, be open and honest about what happening with our bodies. Apparently this is too complicated, or might require that we grow up and deal with reality. I think we have been inundated with information about HIV for decades. Thats not the issue.

  • Thanks for the article. it is one topic that has been on my mind. you just have to trust the person you are with.

  • The Drug Companies have only one interest! Your Money! They have no interest in a cure only monstrance! MONEY! And the Drug Companies have a very bad track record, and are Not to be Trusted!

    Keep in Mind : A false Positive AIDS TEST makes big money for the Drug Companies!

    Get a Second & a Third Opinion!

  • I wish you would do a post on the accounts here on adam4adam from men (mostly young)who are trying to get infected because they think it is hot, or they like the risk factor, i would love to hear what everybody thinks about that

  • What makes me sad is the high cost of the medication. It’s like the gay population is being punished for being gay.

    All over Europe/ Mexico/ Canada the price of medication is a drop in the bucket. I guess they are more concerned about keeping their population heathy vs, ” It’s all about the money USA”

    I am glad to be an American but the older I get the more I see wrong doing.

    What I don’t like to see all the ads on all these sites guys advertising bareback, and all the unsafe sex practices. I’m gay and these guys scare me. Either they have no self esteem or just like being abused. That’s not love in my book or even a good trick. I thought your suppose to feel good about sex. I was always told, “Don’t let one mans pleasure be your pain”

  • Ever since “undetectable” became the vogue I’ve been concerned about both the men stating it and the men reading (and misinterpreting) it. As you note, undetectable doesn’t equate non-transmissable: men who are undetectable are still HIV+ and, really, that is how they should be describing themselves. Yes, undetectable means the virus is harder to catch but it doesn’t mean it’s impossible. I think to state “undetectable” is to suggest “you won’t have to take every precaution with me” and to see it is to think “I won’t have to take every precaution with this guy.” POZ is POZ; use your head (the one on top of your neck).

  • My partner was diagnosed with HIV almost 2 years ago. He is taking a therapy drug regiement of Truvada, Norvir and Prezista. He has been undetectable for a little over a year now and looks and feels great. When I had first heard from the Medical Watch web site newsletter I recieve on my phone as to the updates in the medical industry, I had to ask the question and truth behind the Truvada and I confronted his Dr. She explained to me that for someone who is at risk of HIV and who has a partner that is positive, that as long as they have been taking the drug, Truvada, and it has been in that persons system, then their partner is not in need of taking the medication as a prevention method. Still quetsions remain as to people do not need to place themselves at risk of exposure if they can prevent it. Stay safe, use condoms, always disclose your status with anyone that you plan on having sex with because it is a Felany Offense in most states to lie and knowingly infect someone. Do not take the risk either way.

  • How would sum one get that….drug

  • Good info hope everyone seriously take in consideration the content of this article. @ Aja I hope you were just making a point and you know that small towns and the ederly HIV and STD rates are rapidly increasing.

  • I’ve heard a lot of guys talking about this like a vaccine. It’s not, and vigilance is better relied on than honesty.

  • I really like the way this article is written. being HIV + and undetectable I have found that simplest way to explain being undetectable is stating that the virus is present but not active in my system(
    as long as I faithfully take my medication twice a say)

    I’m afraid that the most effective way to stop the spread of this virus is simply state your status from the start! let the other person make their own choices..I always say I will never let my mistake be someone eleses..

    thank you a4a for keeping this issue present in peoples minds!

    please if anyone has anyquestions just ask! a question never asked isa question never answered!

  • Great. Voluntary Chemotherapy for the rest of your life for something you may or may not have, may or may not get. A chemical AZT based condom, as it were. I’ve been a victim of gross misdiagnosis and acknowledgement by the medical system and establishment of their “mistake”. Not buying into it. They’re not roping me in. Done with this “cause”.

  • Well, it wouldn’t have been unethical to recruit hiv-negative men who have sex with men and tell them about the goal of the study. Give those men the medication and then simply tell them to go and live their sexual lives as they normally would, and ask them to try to keep a record of their sexual encounters. This is critical, because this way you are not explicitly telling them to stop using condoms. Then have them come back after a year or two and then the researchers could evaluate their sexual habits and see whether fewer guys who were given the medication but who didn’t use condoms became hiv-positive than the guys who were given a placebo. Or am I missing something here?

  • I totally agree with this article and its responses. As a HIV pos. Person, I believe that all the help that HIV neg. People can get is better than none at all. Let’s also have in mind that once infected it doesn’t mean you can’t get re-infected. Abstenence is the most secure way to keep safe, yet condoms works as well; just be procautionate on the usage. To be well informed, pos or not, is better than to be confused or have questions. To whomever published this THANK YOU

  • Yes some men are ALREADY using this a sort of Plan B, or even like a Plan A. One man’s profile on A4A said he is negative but takes HIV meds everyday and wants to only do bareback. Like this author said, spending $2,000/month so you can do it raw whenever is just incredible. Incredibly innovative or incredibly irresponsible? I don’t know what to think about this phenomenon. But I do know HIV is still here, these meds aren’t perfect, and if and until they are, anyone can become a carrier and thus a public health risk. As long as these meds are not 100% effective (without a condom), they are NOT surefire prevention from HIV. The science has made progress, but we still have a long way to go.

  • Hello I’m a Poz member I’m upfront on my profile about my status, and I encounter so much stigma its unreal. The stigma of being Poz where I live in the only kind of discrimination I’ve ever faced before. I’m only 21, and this has impacted my life is so many ways, and not all bad. I’m trying to keep active, and healthy. I’m taking time to enjoy things more. I do believe HIV needs to be talked about openly in order to combat stigma, and to educated people. Good communication is always key!

  • I think this column was a very informative piece and well written. The ignorance and ability to turn a blind eye displayed by my brothers and sisters is mind-boggling and heartbreaking. “Kevin”, your comment is what’s unnecessary. Get an education. And “Matieu” learn to spell before you critique somebody. I believe the word you wanted to use was “decent”. Silly unintelligent boys.

  • I totally agree with you on the false sense of security. If they ever come out with a cure or vaccine for HIV, my biggest fear will be a rise in *other* STI’s from idiots fucking bareback like there’s no tomorrow.

  • Feed the People – Stay Alive

  • Let me point something out that keeps getting over looked bout the whole undetectable thing. I am a Medical Assistant, and worked with an HIV specialist and also worked with HIV patients for 17 years. Guys always still freak out at the possibility of sex even if the person with HIV is undetectable, its understandable but its not necessary. Let me use an example..this guy Larry, he is undetectable..has for many years, he meets this guy at a bar named Phil. Larry and Phil go back to Larry’s place, and before sex they have the talk bout Larry being poz and undetectable, Phil is cool with that, just rather use protection to be safe even though he is sure he wouldn’t get it. Now Phil is a bottom, use to getting rather large cocks, Larry on the other hand is a bit smaller than Phil is use to, so Phils ass is able to stretch to accommodate Larry’s almost 7 inches. Larry and Phil get into it hot and heavy, and totally get lost in passion, and Larry shoots a load in Larry, now instantly you think, okay Phil will more than likely get HIV. He very well may not, and this is why. HiIV is the ONLY STD that needs actual work to be transmitted, meaning there has to be blood and no oxygen..HIV dies almost instantly when it hits air..no blood to protect it. Since Phil can usually take like 8 or more, a mere 7 isn’t going to tear the lining of his anal canal, meaning there wont be any air, so when Larry cums in Phil, the cum is just going to be laying on the wall of the anal canal, no tear in the skin. Now if lets say Larry was 10, and Phil wasnt use to that…then there may be a possibility of infection. Im not saying go out and just let small dicked poz tops fuck you so you wont get HIV, Im just saying if you know the guy is smaller than what you normally take and it just happens that you guys get lost in the moment….which we all have done…dont flip out, and dont make a big scene, just go get tested to be safe and just know that you will more than likely be fine. With that said, even with recieving a bj from a poz bottom…no real danger from that. Also, if you tops find yourself with a poz bottom, and they are undetectable, like with I just said with Larry and Phil, its cool, you wont get anything..only way you would get it is if you had a tear in the skin on the shaft of your cock, but there also would have to be a big tear in the bottoms anal canal. Sorry for the long response….17 years in the medical field and also going to be getting my certification to be a personal trainer here …just always love educating others.

  • I met a young guy from my hometown, who now lives in NYC, while he was home over the holiday season. He wanted me to host a gang bang for him at my place, and as he put it “pimp him out” to a bunch of top guys. I gave it a shot, but guys around here are so conservative and lame, I warned him that we might not get much of a response let alone people actually showing up. We invited about 6 guys, only one showed. I was kind of shocked to see that the kid wanted it all bareback. I had not really thought anything about it beforehand. He told me he was on Truvada, and that it was for neg guys to use to help them stay neg. He also told me about his frequent bb gang bangs at home in NYC. I was worried for him, but I figured he is aware of the risk he is taking so who am I to judge. But after reading this article, I wish I had said something, especially now finding out that the trials for this drug were among condom users, not barebackers. I guess that makes sense, but I wonder how many people are aware of that fact. It makes a huge difference. Wish I still had his number…

  • Good post.

  • I find it odd that you are disappointed/upset with “us” –the community– for not doing more about HIV education on a website whose sole purpose exists to facilitate all types of hookups. Perhaps the gay community, should standup to sites like yours and social media apps that prey on our community for profit.

  • As a HIV+ Male, I applaud your blog post. I’m completely open about my status both publicly and online. I know my levels (CD4/Viral load) and get checked every 4 months. I’m happy to say that I’m undetectable and have been for the past 3 years, but even so, I still use condoms when I have sex with my partner.

  • Hi David. That was an excellent article. Yes, gay men in general don’t know how to breach the subject of HIV. It should be discussed with each potential partner. You may ask a potential online date, “oh so you have an eight inch dick, very nice, by the way are you HIV NEGATIVE?” With on-line profiles, people do a profile and they click things, sometimes by accident the actual positive gets clicked as a negative. Honest and dishonest mistakes happen all the time. Sometimes their ignorance is bliss because they never get tested so they answer negative when they are positive. It is when you ask the person directly that their response has no other interface, except from a brain to mouth answer. They can lie if they are positive, and say they are negative, but that is criminal and there are laws on the books regarding this. The PrEP drug is interesting. Big pharma is trying to peddle their goods to healthy people. Now that’s a novel idea. Just like statin drugs, but now we’re off subject. Like cancer, AIDS is BIG BUSINESS. To think a virus like HIV will be eradicated, is wishful thinking. Herpes is a virus and we still have it and so are a slew of other STDs. The problem is people are not vigilant to remember and keep track of who they sleep with. They party when their mind is not at its clearest (drugs or alcohol). They end up at the clinic for a regular STD, get a shot and that’s it. They might remember their last “date” and they might or might not tell them. But two, or more dates ago they are usually oblivious of (keep a sexy journal). The STD is not treated by those other people, they play tag and someone else is IT. The only way to eradicate STDs is to process every human being on the planet and treat them in a trackable manner. That is not happening especially for HIV with all its social implications and the HUGE $$$ that is involved. Sex without drugs and alcohol can be amazing and HOT. Talk to your partners. Express to them the great fear you have of this monster called HIV and listen to their response. You can tell when someone is genuine with their response, but do that IN PERSON, over coffee… NOT right before you have sex, after you just showed up to the guys house at 2am in the morning. Then it’s a mood killer. You are in the prime of your life. This are your “f*cking years” as Eddie Murphy said. Smart sex is great sex and when you’re not apprehensive about it you do it with gusto!! Talk about it guys. There is no shame in wanting to live a long and healthy life.

  • The problem is when people start getting real and talking about how hard it is to live with HIV/AIDS there are those who come out and try to discuss how HIV is now different and how there are new meds.

    It is taboo to talk about but here is a sub culture of gay men who seem to enjoy seeing new people become infected. There are also those out there who are stupid enough to chase after a deadly disease.

    A4A can blog about safety until the cows come home but A4A and other sites send a frighting message that bareback sex is the hottest realest sex there is and that random hook ups are just the greatest things ever. A4A needs to ban ads from bug chasers and people need to be suspicious when they read blog comments that make HIV out to be a walk in the park or compare being infected with HIV to type 2 diabetes.

    I have been told I am a hater by other gay men because I think there needs to be a stronger focus on prevention such as the use of condoms at all times and part of the prevention focus should be having the self respect to get to know a person before you have sex with them.

    Pre infection use of medication should not be seen as a magical cure for HIV and these medications despite all the marketing that will be done to promote them as the holy grail. These are hardcore life altering medications and have some serious risk associated with them including organ damage, possible cancer risk, and in some cases sudden death. If you don’t believe me read the package inserts!

  • heteros are misinformed on hiv-they spread the disease cause they dont wear condoms. gay men do. we did not start the epidemic. i blame them for killing my friends i dont have anymore. hiv is private and confidential. it should stay that way. when in doubt-wear a condom. its simple.

  • Jason, like everytime you post, I will answer the same thing, A4A is NOT responsible for everybody’s acts! We cannot control every ads, every profiles and every banner ads on the site, we don’t have the ressources to do so as our site is free and we dont have 300 staff like our competitors who manage a paying site. We gladly offer health support and ressources for people who want info about stds and HIV. We even have health specialist with a profile on A4A, so you can chat with them. The full list is here : http://www.adam4adam.com/?section=20&view20=17
    Dave

  • MGreggles : why?

  • great infor and appreciate the time u took in researching for the artical. can someone tell me the difference between hiv+ and AIDS. my brother who will not talk about it is now pos. when it was discovered 8 years ago he was on nhis death bed with full blown AIDS. now he is undetectable. does he still have AIDS, or just HIV+?

  • Tks for the information, I have a friend that is HIV but he says with the drug he on that he is undectable n his blood work, I am so glad that i read your article and that it still can be tranfer with unprotected sex, Keep us inform if you don’t who will.

  • I just read Michael Shernoff’s excellent book entitled Without Condoms: Unprotected Sex, Gay Men, and Barebacking. It’s written pre-PrEP, but the other topics are still relevant.

    In his conclusion, he stresses how we have responsibility toward each other–that men who bareback affect not only themselves, but all of us. By eroding community norms around safe sex, he asserts, their behavior increases the risk for more gay men to become infected with HIV.

    I agree with his assessment.

    If Adam4Adam wanted to take responsibility for its part in eroding community norms away from safe sex, it would all remove bareback sex from its porn sites, remove the “Anything Goes” option in the profiles, and redesign profiles to encourage discussion about HIV status among prospective partners.

    Adam4Adam and similar websites have vast responsibility for creating a riskier environment for all gay men.

    What will A4A say for itself?

  • I agree with the user that posted that the blame for the spread of HIV should be placed where it belongs. I find it extremely amusing when I refuse to date or hook up with someone, that they are offended. I am trying to protect my health.I have family,friends, co-workers, etc. I feel a responsibility not only to myself but to them to stay healthy. I know an accident can happen at any time, but I’m not going to run into traffic to speed up my death. If I was to die, I know people will miss me a lot ! Sometimes I wonder if the guys that BB,do drugs or have multiple partners just are not as lucky as I am to have people that really care for them in their lives. I guess they try to compensate for the lack of love with sex. Take care of yourselves guys. Look around you and see there is so much more to life to enjoy.Love yourselves first and then realize that your health is important.

  • To the moderator who responded to my post I honestly feel A4A only has safe sex information and allows health specialist to cover themselves. At the end of the day A4A is a hookup site ran by people who really have no desire to better the world around them. I mirror what Ray said and challenge this site to make changes that will reduce risk. No one can tell another person what to do, but you as a site can make changes that helps reduce STD transmission. To quote Ray who makes a very good point:

    “If Adam4Adam wanted to take responsibility for its part in eroding community norms away from safe sex, it would all remove bareback sex from its porn sites, remove the “Anything Goes” option in the profiles, and redesign profiles to encourage discussion about HIV status among prospective partners.

    Adam4Adam and similar websites have vast responsibility for creating a riskier environment for all gay men.”

    I ask the people who run A4A are they man enough to help make change, or are they going to continue to act as enemies of the gay community and prey on people who are thinking with the wrong head?

  • Haven’t even bothered to read but how about not being ruled by your penis!

  • The initial question was ‘using HIV meds to stay HIV free’. Since we digressed somewhat it did make the discussion more interesting. I’m puzzled why people aren’t held as responsible for transmitting herpes, syphilis, and other sti’s. I believe that because of the huge part of the population that initially picked up HIV were gays that they are still being unfairly targeted. My very young straight friend got genital herpes from his first female fuck, He went thru (and still is) a traumatizing time dealing with it. She is not held responsible. Unless you’re mentally retarded or getting force raped then I think we all have enough education now to decide how safe we are going to play, risk levels etc, and should own our actions.
    I recently read that the average 21 year old who now gets HIV should live to be 73 if he lives a normal life and gets on one of the new therapies. Interesting.

  • Jason, I think your assumptions need a bit more information.

    The safer sex information posted on the site and the site encouraging and helping public health to be part of the community are the result of one thing – a desire by everyone at Adam4Adam to make a difference.

    Your cynical viewpoint is ill informed. There is no need for Adam4Adam to ‘cover themselves’. What people do when they are face to face has nothing to do with us. We are a website, not a physical location – that is a very different scenario.

    Your simplistic belief that we have the ability to foster behavioral changes that will reduce risk is naive at best.

    We could post all types of warnings, provide thousands of pages of information but the truth is we cannot make a difference when it matters – when two men are face to face in the bedroom.

    Education and information does not equal long term prevention. Information can influence behavior change for a short period of time, but there is no evidence that this change is permanent. For example: I have known men in public health to become HIV positive WHILE they were in public health. Not because they did not have the information but because they made choices that were based on factors other than information – what happened when they were face to face and factors outside of information trumped whatever they ‘knew’ when they were face to face with another man in the bedroom.

    I propose that you have issues with gay men and you need a target for your internalized issues, after all, what is Adam4Adam? The website provides empty space and it gets filled with gay men doing what they want behind a false curtain of anonymity. Even the advertising is provided based on what gay men want (voted on with their dollars). The site and everything in it has been created based on what he community is and wants.

    I invite you to take a more objective look – public health spends millions of dollars trying to change behavior and yet infection rates for all kinds of diseases are still increasing. You make assumptions that people are willing to change their behavior and that all they need is someone to ‘guide them’. Behavior change is not that simple, people resist the attempt of others to control them.

    Your foundational logic is flawed – you assume that the site creates and influences the community, the truth is that the site responds to the community and the community reinforces itself through the site, Adam4Adam does not create the community – we are a reflection of the community.

    We allow space for public health to provide information and we welcome any new ideas from public health to help reduce the rates of HIV and STD – but Public Health has no new ideas, is terrified of technology and when it comes to behavioral change, is basically a lame duck that is starting to realize the same thing – people do what they want regardless of the information they have – the factors that influence behavior go extremely deep in the individual. The issues as to why men have unsafe sex rarely have to do with a lack of information..

    The truth is that each individual must care enough about himself to protect himself. No amount of information on safer sex makes any difference if a person is willing to compromise what they know (safer sex) for what they want (bareback sex).

    I encourage you to read up on issues that influence behavior and self image like level of income, power, Social position, education, Occupation, Ethnicity / race and how these and other key determinants contribute to decision making and behaviors.

    It is fascinating to me that anyone would call a website a risky environment. The risky environment is the bedroom and we have absolutely no influence as to what happens there.

  • You would think that since HIV has been around since the early 80’s there would be some sort of vaccine by now. It’s not like HIV mutates every year or so. Vaccines would be the best way to protect the gay community, since it would not depend on someone being responsible in their behavior, especially in the heat of passion, or after drinking (or anything else). It might require a booster every few years, like a tetanus shot, but it really would be the best solution. sadly, curing HIV would likely be impossible once a person is infected.

  • Good article! We need to talk about it again, again, again! Til people start changing there sex habits. Get regular testing for HIV and STD’s. Sharing the results with their sex partner. Wear condoms or wear condoms until they’re in a long term relationship and feel comfortable. It’s not just gay men getting it, women too! Passing it onto our children! More education programs about healthly sex! More mental health services. More safety in the public to stop the bullying to people aren’t so shallow. Humans behave a certain way to fit in. They may have sex wtih someone a certain way because they thought it was going to turn into a relationship and it’s just a hook up without any protection. Learn what HIV stand for and education for it. AIDS stand for and education for it. STD education. Where to turn to for help in crisis, sucidial, etc. Where they could be free clinics to get tested or education about diseases, sex questions, bullying, medical help, mental help, etc.

  • I don’t fully agree with part of the premise of this article. That part is the premise that HIV+ people on medication can still transmit virus. Almost 5 years ago, the Swiss medical authorities determined that HIV+ men who were on medication and undetectable could not transmit virus. There is a new study out that shows that a certain percentage of undetectable HIV+ med DO shed virus in semen. However, the number of virus particles per ml is quite small compared to the amount shed by someone HIV+ not on medication and, as with many other disease-causing viruses, there is a certain threshhold of viral particles needed for actual disease transmission. That minimum amount is currently unknown, but it’s likely to be higher than the amount these men are shedding in their semen. Incidentally, nearly all the men shedding virus had concurrent STD infections of the penis. American doctors are being ultra-careful in their guidelines because there is no data on how much virus is needed to transmit disease, and nobody wants to get sued for that one in a million exception. Nonetheless, ALL studies show that complete viral suppression with medication (undetectability) reduces transmission by at least 96%. If you check your stats, that’s about equal to the protection given by condoms. Obviously, the safest of all possible routes is having an undetectable HIV+ person also use a condom. But the reality is that the VAST majority of transmissions occur between people who do not know their status and their sexual partners and are not receiving treatment. Viral load in untreated people with HIV varies from 100,000 to 1,000,000 viral particles per ml. Viral load in those few HIV+ undetectable people with virus detected in semen ranged from 153 to around 2000. In an ideal world, ALL sexually active people would have an AIDS test every 6 months, and people whose test results were positive would be put on medications immediately and told to refrain from sexual activity until their viral loads were undetectable. In that ideal world, transmissions would essential end within 3 or 4 years and that would be the situation until all the people with HIV died in their natural lifespans. It seems counter-intuitive, but I would rather take my chances on someone who was HIV+ and could prove that he was undetectable than I would with someone who didn’t know his status or had last been tested 2 years ago no matter what the activity.
    http://aids-clinical-care.jwatch.org/cgi/content/full/2012/423/1

  • Whats interesting as I read everyones comments, is that no one has mentioned the fact while hiv tranmission rates are declining worldwide, they are actually rising in developed countries like the us or the uk. I think the main problem lies within the ourselves and the gay community. I knew the risks of having unprotected sex and i still did it anyways. Now I get to live with being positive for the rest of my life. And its not the gay community thats helping me through this ordeal, its all the loving straight friends and family that keep me strong. I face nothing but condemnation and prejudice from other gays when i disclose my hiv status. We need to stop thinking with our dicks(i know, its hard) and actually work together to get through this blight on humanity. We need to rebuild the gay community and we need to realize that hiv will only get worse if we dont something about it.

  • I have a question for Bren and all other HIV+ guys. In what ways does HIV awareness needs to change in the gay community to reduce new infection rates? What did you NOT know about HIV/STI prevention that lead you to being infected? Where is the education going wrong?

    Do HIV+ guys consider it to be prejudice and discrimination from others in the community when HIV negative people refuse to have sex with you?

    I strongly believe HIV infections in the gay community is a result of failure to engage in social/cultural education in the gay world. Topics on promiscuity, body image, drug and alcohol dependence and promotion in night clubs, MUST be openly discussed. Because so far the strategy of free condoms and free HIV testing has not reduced HIV rates in the gay community.

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