More PrEP Propaganda from Queerty?

I'm missing the link between your title and the substance of the article.

PrEP and or PrEP and condom usage possibly could have kept these kats HIV free. What am I missing?

 

Got It...in a nutshell:

PrEP does not, cannot correct nor prevent risky or irresponsible behavior.

Ni@@a you right.

 

It's as if common sense and understanding of Darwinian natural selection is missing with Americans; idiot anti-vaxxers on the right, irresponsible bug chasers on the left. Antibiotics were a true revolution in human history. Then we overused them ("Doc, I got a hangnail!" "No problem, here's a prescription for a troth-sized helping of ciprio!"). Bodies get used to medicines, bugs and germs do too. Soon, effectiveness goes down the drain. Same will happen with Truvada if not introduced and managed well among populations.Plus, it's only for HIV. It's like dudes act as if there aren't at least two dozen other STDs that Truvada does nothing for, or that condoms are still the main way to reduce transmission of most STDs.

Sorry, I'm in the public safety and health management field, so rant. Queerly is the web site equivalent of a 2-day, ecstasy fueled rave of shirtless twinks. I can't even be bothered for their (largely) poorly edited and sourced content.

 

This. I just don't understand why people are not worried about the burny, scrachy, bumpy, and scaly infections. HIV isn't the only thing to worry about.

 

I didn't listen to the interview {yet} but that's the impression I got from the article as well. But I look at it from both sides of the fence, it could've prevented his HIV infection had he taken it (if he really even has it, could just be propaganda to push the PrEP pill) and I also think it gives a lot of gay dudes an excuse to continuously have unprotected sex under the illusion of "no repercussion".

 

“I thought that only highly promiscuous and risky sex practitioners would take this. I went through this process of ‘slut shaming’ myself. I was still very naïve at this point.”

Well guess what? I was a slut and I did not get HIV. And apparently if someone thought that you were a risky sex practitioner, they would have been right, because otherwise you would not have gotten HIV. You get it from having risky sex.

It is not about promiscuity or sluttiness really. You can be a slut and NOT engage in high risk behavior, either by not doing certain things, or using condoms. People have been doing that to remain HIV negative for several decades, long before PREP ever came about. I was not an angel, but I did not do the 'high risk' stuff. i did take some chances, but not the biggest chances with the greatest risk.

I have said it before and I will say it again-when it comes to HIV, it is mostly less about who or how many, but more often about what you do, and how you do it.

They should also be getting those HPV shots, and Hep shots, etc. along with the condom/condom&PREP usage.

 

The whole "slut shaming" thing is sad and another 20 threads in and of itself! I don't get into judging other peoples' quality, participation and frequency of acts as long as everyone's consenting and lawful, and I wish our national health policies and health administration culture reflected as much.

Society needs to be more direct and mature as a society in dealing with human sexuality, but not in the flippant, facile way Queerty types go about it. Go on YouTube and check out how direct and frank (and visually "explicit") the US military was in WWII (1940s!) training films dealing with STDs and soldiers, even having a soldier or sailor in the film demonstrate how to put on the condom without using a stunt penis (lol). Decades later, one Surgeon General catches hell for pointing out the medically obvious, that a prophylactic is a cheap, effective means of stemming disease (Koop and condoms); another gets fired for pointing out a natural activity in which many animal species besides humans engage, can also stem disease and unwanted pregnancies (Elders and masturbation). We've gotten used to, if not perpetually annoyed and pissed, at this sh*t from the right. We sure as hell don't need LGBT bitchiness like "slut shaming" creating a culture that further encourages folk to hide, ignore ir otherwise not address their own behaviors and practices.

 

'He worried about what starting PrEP might say to people about his sexual behavior.'

He was worried about being thought of as a slut instead of being worried about his own real sexual behavior, which apparently was not slutty but apparently risky and resulting in him unfortunately getting HIV. That and that PREP is one tool and not a panacea for everything and that there are even other STD's out there that may kill you sooner (HEP) should have been the message portrayed.

And he was right about being labeled as a slut. Gays are so quick to judge eachother and the slut label can hurt you because people not only have negative perceptions about others, they act on those perceptions too, and cause real life consequences. Spreading rumors, spreading lies, shaming and shunning are behaviors and not thoughts or opinions. It is too bad he focused on that and not on what he was actually doing.

If we did not have such religiously oriented fukwads in charge in so many places and comprising so much of the public we would have PREP usage when warranted, condoms(and their usage), vaccinations for certain HEP strains and HPV, good sex ed, etc. acknowledged and pretty basic among the population. Not only less STD's (I will admit I got a few myself over the years-not perfect here), but less unwanted pregnancies so the rabid anti-abortion crowd could also sit the hell down and stay seated.

HIV just can't be taken lightly-and you can talk about it without shaming those who have it. Yes there may be a cure a few years away, but there could also be a new resistant and deadlier strain coming out in a few years too. I read somewhere where just taking the anti-HIV meds as they are prescribed takes about five years off your life span. They are serious and strong medications that have side effects and long term effects. I wonder what they might find out abut PREP on down the line too. Just so many young people living for the day only. (I did too to an extent, it is what it is)

*yeah I know people are stupid basically so shit would still happen, it would just happen a little less often. This has to be the message out there or that CDC study about half of all black gay men being HIV positive will become a reality.

tl;dr be smart and safe!

 

Yeah, thats the thing about Truvada, they clinically know what it does for HIV in the short term, but it hasn't been around long enough to guage damage to livers, etc. It's like when everyone worried about cell phones and waves. We now have decades of phone use to draw conclusions as to the worries about usage and whether the fears are valid or not. We are not there yet with PrEP/Truvada.

Do they make rapid result blood tests and monitors that can quickly detect VD like a blood sugar monitor? It'd be something if you could hookup with someone, do a home strip test before dropping the drawers, and know with a little better certainty your likelihood of coming down with (fill in the blank).

 

I think y'all already know where I stand on PrEP.

I don't accept this critique. Both components of Truvada - tenofovir and emtricitabine - have been around for more than a decade. In fact, they have used in combinations with other drugs for treatment of HIV infection for more than a decade. Complera and Atripla are examples. So we do have data on side effects. They are safe. This is the reason why the WHO has them on a select list of "essential medications". That being said, doctors periodically monitor for problems with bloodwork since there have been isolated reports of metabolic problems, kidney damage, decreased bone density and even liver damage; again these are rare. If you are taking antiretrovirals, you must see your doctor periodically to ensure that these problems aren't developing. And if you don't see a doc for periodic checkups/don't communicate at all, PrEP will be stopped. I know because I've stopped PrEP for patients in the past. I've said it before and I'll say it again- you don't screw around with anti-retrovirals. Also, we need to remember that Truvada for PrEP is NOT supposed to be permanent. If you are in a low-risk situation, you don't need PrEP!

No, there are no rapid tests. I'm sure it could be an interesting entrepreneurial venture though. There are rapid tests for HIV-- 4th generation tests exist, and a few 3rd gen are available over the counter (Oraquick). I don't think the Determine (4th gen) is available in stores. So, if you're having sex, wrap it up!

Big take-away- communication is important people. Communicate with your doctor. If they are uncomfortable with whatever the conversation is (including but not limited to sex), find someone who will talk to you. Just, please, talk.

 

Cool, thanks for the info! Like I always say, we laypeople always have to take media reports with a grain of salt. It's good to hear from an expert.

I learned that lesson the hard way. I had a good doctor for years. I always heard that you should let your doctor know everything that's going on in your life. So, I told my doctor of many years my orientation and he freaked out. Had to start all over with a new doctor (cue Jody Watley)

 

I'm sorry that this happened. It is absolutely appalling.

 

Yeah, but it is what it is. Doctors come from all backgrounds, belief systems, etc. so it's to be expected that some get upset with "the gays." I look at it like Ocky's perspective on dating app preferences from the podcast; at least the doctor let me knew where he was coming from so I didn't have to waste time with him anymore.

Speaking of treatments, what's your take on the HPV vaccine? I know they encourage young people to get it, especially girls. I'm definitely not an anti-vaxxer. Is there any effectiveness for other age groups? It seems to me that, if there is no age related barrier, it would be a good thing to get, due to HPV's relationship to oral and throat cancers? After all, the reality is that almost no one gives head with condoms.

 

HPV is very common- something like 1/4 of people end up being exposed to it and are carriers. What is different is the strain. Some don't really do much, some go on to cause genital warts, others still cervical, oropharyngeal and even anal cancers. Cervical cancers kill women with alarming frequency. After vaccination started for women, numbers of new cervical cancers plummeted something like 50%. Genital warts by even more. This is a victory.

Multiple HPV vaccines exist-you may have heard of Gardisil with covers 4 types, but there is both an older and newer version.

But let's talk about MSM groups.

The vaccine has been studied and it works better for 9-15 year-olds than for 16-26 year-olds. The immune system simply seems to respond better to vaccines, including HPV vaccines, when you're younger. Before 26 years of age, HPV vaccines seem to be quite effective in preventing genital warts and anal cancers. We don't have great data on oral/throat cancers since they are more rare, but yes, HPV is implicated in many forms of it. The vaccine is NOT used in MSM above 26 years of age since there is no information available regarding efficacy for prevention at that age. MSM should be vaccinated against HPV up until 26.

Best of luck getting a new PCP.