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More PrEP news

This should shock absolutely no one.
 
I plan on talking to my doctor about prEP during my next checkup. An ounce of prevention. . .
 
Well this isn't shocking. When I was in a study which had me on a daily regiment, I did things...that even i find myself, months later, baffled by. It gives many a false sense of invisibility. And I am talking about those who don't use it in conjunction with a condom: "What other STDs? ah!"
 
Here ya go:

The good news: A pill from Gilead Sciences Inc. stops HIV infection among people at high risk of contracting the AIDS virus.

The bad news: Men taking the drug to prevent HIV appear to be having more sex without a condom, putting them at risk of contracting other sexually transmitted diseases.

The numbers, from a survey of men in a Kaiser Permanente AIDS prevention program, offer a mixed report for Foster City-based Gilead's (NASDAQ: GILD) Truvada, the only drug approved by the Food and Drug Administration as a way to prevent HIV infection.

More than 500 people have started taking Truvada once a day as pre-exposure prophylaxis — or PreEP — through Kaiser's HIV care and prevention program in San Francisco, said program director Dr. Brad Hare. Among those taking PrEP, he said, there has been no increase in the number of their sexual partners and no new HIV infections.

"It is used to prevent HIV — and that seems to be working," Hare said.

The eye-popping statistic, however, is a 45 percent increase in condom-less sex. But that number comes with a caveat: It represents only self-reported condom use by a subset of about 90 PrEP patients in the Kaiser program.

"We can't say how that applies to the entire group of people on PrEP," Hare said.
The majority of PrEP users in the Kaiser program are men having sex with multiple men, Hare said, but the program also includes some women, transgender individuals and injection drug users.

The AIDS Healthcare Foundation — a Los Angeles-based organization that has criticized the FDA for approving Truvada as PrEP and the Centers for Disease Control and Prevention for its PrEP use guidelines— had warned that Truvada as a preventative drug would lead to condom-less sex.

"Why would men take this medication if they intended to use a condom?" said Michael Weinstein, president of the AHF. "It's utterly predictable."
Truvada, a combination of the drugs emtricitabine and tenofovir, was approved in 2004 as a treatment for people already infected with HIV. It was approved for PrEP in July 2012.
PrEP has been hailed by public health officials and researchers as a breakthrough strategy — but not the only way — to prevent AIDS. They stress that PrEP patients wear condoms.
Truvada's uptake for PrEP, however, has been slow, in part because of culture and its roughly $14,000-a-year cost. But the number of people starting a PrEP regimen has increased since the start of the year, Hare said Dec. 1 at a World AIDS Day community forum at the San Francisco Department of Public Health.

That uptick may be tied to a disappearing stigma around PrEP use. In September, for example, San Francisco Supervisor Scott Wiener wrote a Huffington Post item about his experience with PrEP.

"The reasons people are coming in are different," Hare said. "People are seeking PrEP because their friends are on it and they're sharing stories about it changing their lives. Patients are coming in and saying, 'It must be for me, too.' "

Still, one-third of those referred to Kaiser's program choose not to start PrEP after speaking with a counselor, Hare said. Cost, insurance coverage and, to a lesser degree, kidney toxicity in 1 percent to 1.5 percent of users, he said, remain as issues.

In clinical trials — including one overseen by the University of California, San Francisco-affiliated Gladstone Institutes — PrEP has staved off HIV infection in more than 90 percent of users. But Weinstein's AHF has argued that the efficacy numbers drop sharply — below 50 percent — when accounting for study enrollees that didn't take Truvada as they should have.
 
I would worry about the effects of the drug on the rest on the body.


Condoms are less of a worry.
 
Condoms are great help if you're going to have sex with someone who has a disease. If my guy worked at a hospital, picked up the wrong needle, and got HIV, we would be using condoms instead of giving up our sex life after 17 years.

The thing is, people are taking the same approach for a one-time random orgasm with someone they're never going to see again. Is that one orgasm with someone whose real name you might not even know really so incredibly important?

Yeah, maybe, for someone who is lonely enough and horny enough at the same time. But it doesn't obviously make sense on its own.

The other thing about HIV is the way it spreads. It kind of goes off like a domino, infecting one person, then their next new hook-up a week or two later, then the next stranger another couple of weeks after that, in a chain reaction of randoms. Or like a disease grenade at sex parties. People don't even realize they've picked it up before they go giving someone else a chronic life-long infection. Was that orgasm so important to them that they'd make another person take medication for the rest of his life?

Condoms can break that chain, usually. But as gay men why are we setting up those dominoes in the first place?

We've spent 30 years telling people to carry on sportfucking half the town for as long as they like, as long as they wrap it in plastic. If that worked, HIV would have died out 20 years ago. We don't ask the right question.

Once again I'll post Elizabeth Pisani, who makes totally different points to what I do, but still has lots to say, and who educated me about how HIV travels in bursts.
https://www.youtube.com/watch?v=LoXAAEy6YQU#t=450
 
Condoms are great help if you're going to have sex with someone who has a disease. If my guy worked at a hospital, picked up the wrong needle, and got HIV, we would be using condoms instead of giving up our sex life after 17 years.

The thing is, people are taking the same approach for a one-time random orgasm with someone they're never going to see again. Is that one orgasm with someone whose real name you might not even know really so incredibly important?

Yeah, maybe, for someone who is lonely enough and horny enough at the same time. But it doesn't obviously make sense on its own.

The other thing about HIV is the way it spreads. It kind of goes off like a domino, infecting one person, then their next new hook-up a week or two later, then the next stranger another couple of weeks after that, in a chain reaction of randoms. Or like a disease grenade at sex parties. People don't even realize they've picked it up before they go giving someone else a chronic life-long infection. Was that orgasm so important to them that they'd make another person take medication for the rest of his life?

Condoms can break that chain, usually. But as gay men why are we setting up those dominoes in the first place?

We've spent 30 years telling people to carry on sportfucking half the town for as long as they like, as long as they wrap it in plastic. If that worked, HIV would have died out 20 years ago. We don't ask the right question.

Once again I'll post Elizabeth Pisani, who makes totally different points to what I do, but still has lots to say, and who educated me about how HIV travels in bursts.
https://www.youtube.com/watch?v=LoXAAEy6YQU#t=450

Why does any smoke cigarettes? Why does anyone drink? Why does anyone drive a car? If everyone stopped doing that there would be a lot less death, right?

Ridiculous perspective, sorry. Maybe if sex drives didn't exist, your point would make sense but it doesn't. If you practice safer sex, your chances of catching HIV are infinitesimally small.
 
If I remember correctly, Andrew Sullivan (The Daily Dish) posted a letter recently from a physician who stated that it was important to understand that the results of the Truvada study showed that of the men having unprotected sex using the drug had a 3% infection rate, whereas the men not using the drug had a 5% infection rate. That is, with Truvada you had a 97% chance of being infected and that without the drug you had a 95% chance. This is a 2% difference, results that seem less than spectacular. (Sullivan, by the way is a big proponent of the drug.)
 
Why does any smoke cigarettes? Why does anyone drink? Why does anyone drive a car? If everyone stopped doing that there would be a lot less death, right?

Why does anyone quit smoking? Why does anyone cut back a bit instead of binging until they puke and pass out every weekend? Why does anyone take drivers' lessons?

Because people are smart enough not to want to die from making stupid choices or from keeping up the stupid choices they made in the past.

If a person has to drink every day to get by, we wouldn't tell them Oh hey up till now you had to have your stomach pumped every weekend to drink that much. Now you can take TruDrinka™ and keep it up my son, party hard. We'd tell them to stop fucking drinking out of control or die of alcohol poisoning.

Meh.
 
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