scared of being cheated on and catching HIV

[Auburn]

I hear that most guys who get HIV are guys who think they are in monogamous relationships but , in reality, their partner is cheating on them and has contracted HIV and brought it back to them. I am single now but I am afraid to enter into a relationship with any guy because I am afraid that if I got into a relationship and we got deep enough into the relationship to where my partner would want me to stop using condoms, that my partner would cheat on me, contract HIV , and give it to me. I have had several friends who have contracted HIV from guys who they thought they were with in a monogamous relationship, but their partner was , in fact, cheating on them. Do any of you have this same fear? how have you gotten over it? This fear is ruining my chance at finding love.

 

[kallipolis]

I hear that most guys who get HIV are guys who think they are in monogamous relationships but , in reality, their partner is cheating on them and has contracted HIV and brought it back to them.

Most HIV infections are contracted by those engaged in unsafe sexual practices, and/or heavy drug use employing syringes.

I am afraid that if I got into a relationship and we got deep enough into the relationship to where my partner would want me to stop using condoms, that my partner would cheat on me, contract HIV , and give it to me.

In my loving relationships, over many years, I have always insisted on using condoms...no exceptions...no discussions...never contracted a sexually transmitted infection, from a loving partner....I am with my current partner for three, and half years without even contracting a cold...

Fear of the unknown can be simply dispelled by insisting that condoms are used on every occasion...without exception.

A heightened anxiety syndrome based upon imaginary fears can trigger a variety of depressing, and debilitating conditions that deny us our birth right to live in freedom from fear to live a happy, and fulfilling life.

Safer sex practices remove the fear factor....contributing to the growth of a mature, and happy loving relationship with ones partner.

 

[Benvolio]

To be safe, kalipolis, but even safer sex is no absolute guarantee. Accidents happen. Another partial solution is to agree with your partner to periodic testing. Avoid a long term relation until you find a partner who is committed to safe sex as you are. And remember, life is never absolutely safe. We could be struck by lightning, hit by a truck, or develop an incurable cancer at any time. No one lives forever.

 

[Benvolio]

That should have read: To be safe, Kalipolis is correct, but.....

 

[kallipolis]

To be safe, kalipolis, but even safer sex is no absolute guarantee. Accidents happen. Another partial solution is to agree with your partner to periodic testing. Avoid a long term relation until you find a partner who is committed to safe sex as you are. And remember, life is never absolutely safe. We could be struck by lightning, hit by a truck, or develop an incurable cancer at any time. No one lives forever.

There are no guarantees....even crossing a road can be life threatening....but we all take reasonable risks at living life to the fullest. Control freaks...the OCD personality may favour your suggestion....I am not in that category preferring to observe safer sex practices that reduces risk of contracting sexually transmitted infections to the absolute minimum....and even loving partners can lie....and do.

 

[KaraBulut]

I hear that most guys who get HIV are guys who think they are in monogamous relationships but , in reality, their partner is cheating on them and has contracted HIV and brought it back to them. I am single now but I am afraid to enter into a relationship with any guy because I am afraid that if I got into a relationship and we got deep enough into the relationship to where my partner would want me to stop using condoms, that my partner would cheat on me, contract HIV , and give it to me. I have had several friends who have contracted HIV from guys who they thought they were with in a monogamous relationship, but their partner was , in fact, cheating on them.

Guys get HIV from sharing needles or getting fucked in the ass without using a condom. Cheating or not cheating has nothing to do with the prevalence of HIV. There's no evidence that people in relationships are infecting their partners.

Do any of you have this same fear? how have you gotten over it? This fear is ruining my chance at finding love.

You're in the situation of someone who is afraid of flying because they're afraid that the plane will crash. It's possible that planes can crash- it does happen. But the statistical evidence (and rational thought) says that it's unlikely that you or anyone you know will contract HIV from a partnered relationship.

If this is really the barrier that you believe it to be, you need to work this out with a therapist. It's an irrational fear. It's time you fixed this and got on with your life.

 

[bankside]

I have had several friends who have contracted HIV from guys who they thought they were with in a monogamous relationship, but their partner was , in fact, cheating on them.

This is a warning bell for me.

I don't know anyone like that. Most of the people I know well are all in long-term relationships. One friend who has never been very good at relationships just had another one go down the tubes after 5 years, and it wasn't a drama of cheating and betrayal or anything like that, even then they were still adult. Some people joke about a 5-year relationship being forever in "gay years" but in our social circle, he's actually the flaky one bouncing from one guy to another and even he takes 5 years to do it.

So my own advice for myself is, monogamy=freedom from the risk of disease, and also monogamy is real.

But I am willing to admit that maybe I live in a bubble of freakishly monogamous, grown-up, responsible, trustworthy, loyal people who you really could trust your life with. That's true of my guy. My life is in his hands, and I don't worry because I know what kind of man he is.

The thing is, if I do live in a bubble, then maybe you do too. If you know more than one person with a story of getting HIV from a monogamous relationship, maybe it is just a fluke, or maybe the people in your part of the world aren't all that loyal or caring or filled with basic human decency toward the men they pretend to love. Because getting a disease from a stranger and giving it to someone you love is about the lowest of the low.

So I know the official line is "oh just wear a condom and don't worry about it." But I couldn't get hard or enjoy myself if I thought the guy I was fucking was just some random douchebag carrying a disease, and who wouldn't give a damn about my health unless I insisted on the condom. For me, I have to build trust with my guy over time, learn he's reliable, learn he's able to have a grown-up relationship, for me to even find him arousing. I'm not built for hook-ups with strangers, and that has saved me a lot of problems with my health.

I don't know your friends or the people you know. But if cheating is common in everyone you meet, maybe it is time for a new set of friends with less drama and better health.

 

[Auburn]

Guys get HIV from sharing needles or getting fucked in the ass without using a condom. Cheating or not cheating has nothing to do with the prevalence of HIV. There's no evidence that people in relationships are infecting their partners.


You're in the situation of someone who is afraid of flying because they're afraid that the plane will crash. It's possible that planes can crash- it does happen. But the statistical evidence (and rational thought) says that it's unlikely that you or anyone you know will contract HIV from a partnered relationship.

If this is really the barrier that you believe it to be, you need to work this out with a therapist. It's an irrational fear. It's time you fixed this and got on with your life.

Well, I was just making that statement about cheating based on my own personal experiences. Once you tend to run into several people who cheat on their partner, you start to wonder if its commonplace especially since you always hear the stereotype that gays tend to cheat ( non gays cheat too of course but you get what im sayin)

This is a warning bell for me.

I don't know anyone like that. Most of the people I know well are all in long-term relationships. One friend who has never been very good at relationships just had another one go down the tubes after 5 years, and it wasn't a drama of cheating and betrayal or anything like that, even then they were still adult. Some people joke about a 5-year relationship being forever in "gay years" but in our social circle, he's actually the flaky one bouncing from one guy to another and even he takes 5 years to do it.

So my own advice for myself is, monogamy=freedom from the risk of disease, and also monogamy is real.

But I am willing to admit that maybe I live in a bubble of freakishly monogamous, grown-up, responsible, trustworthy, loyal people who you really could trust your life with. That's true of my guy. My life is in his hands, and I don't worry because I know what kind of man he is.

The thing is, if I do live in a bubble, then maybe you do too. If you know more than one person with a story of getting HIV from a monogamous relationship, maybe it is just a fluke, or maybe the people in your part of the world aren't all that loyal or caring or filled with basic human decency toward the men they pretend to love. Because getting a disease from a stranger and giving it to someone you love is about the lowest of the low.

So I know the official line is "oh just wear a condom and don't worry about it." But I couldn't get hard or enjoy myself if I thought the guy I was fucking was just some random douchebag carrying a disease, and who wouldn't give a damn about my health unless I insisted on the condom. For me, I have to build trust with my guy over time, learn he's reliable, learn he's able to have a grown-up relationship, for me to even find him arousing. I'm not built for hook-ups with strangers, and that has saved me a lot of problems with my health.

I don't know your friends or the people you know. But if cheating is common in everyone you meet, maybe it is time for a new set of friends with less drama and better health.

I wish I knew the people you knew. Sounds like you have surrounded your self with the right people.

 

[mbamike]

Condoms, prEP (Truvada) and abstinence are the tools available to prevent one from contracting HIV. Pick which tools you want to use. Your health is YOUR responsibility.

 

[KaraBulut]

Well, I was just making that statement about cheating based on my own personal experiences. Once you tend to run into several people who cheat on their partner, you start to wonder if its commonplace especially since you always hear the stereotype that gays tend to cheat ( non gays cheat too of course but you get what im sayin)

Cheating is a different issue.

Generally, in same sex relationships, there's a discussion about what the terms of the relationship are and what constitutes "cheating".

 

[palemale]

To be safe, kalipolis, but even safer sex is no absolute guarantee. Accidents happen. Another partial solution is to agree with your partner to periodic testing. Avoid a long term relation until you find a partner who is committed to safe sex as you are. And remember, life is never absolutely safe. We could be struck by lightning, hit by a truck, or develop an incurable cancer at any time. No one lives forever.

To me, safe sex practices function the same way vaccinations, and the theory of herd immunity, do. A very small percentage of people who are vaccinated still don't become immune. If the "whole herd" gets vaccinated, however, it greatly reduces the chance that those who do not become immune will still not become sick. If one restricts himself to having sex with people who use condoms, and a condom breaks, the chances of becoming infected are greatly reduced, exponentially reduced, compared to one who rarely practices safe sex.

 

[mbamike]

To me, safe sex practices function the same way vaccinations, and the theory of herd immunity, do. A very small percentage of people who are vaccinated still don't become immune. If the "whole herd" gets vaccinated, however, it greatly reduces the chance that those who do not become immune will still not become sick. If one restricts himself to having sex with people who use condoms, and a condom breaks, the chances of becoming infected are greatly reduced, exponentially reduced, compared to one who rarely practices safe sex.

Let's substitute prEP for condoms.

If one restricts himself to having sex with people who [STRIKE]use condoms[/STRIKE] are taking prEP [STRIKE]and a condom breaks[/STRIKE], the chances of becoming infected are greatly reduced, exponentially reduced, compared to one who rarely practices safe sex.

 

[KaraBulut]

Let's substitute prEP for condoms.

The difference, though, is that we have nearly 30 years of evidence of risk reduction- not only in HIV but in all STDs- to support the conclusion that condoms work.

The PrEP recommendation was based on a very limited group of studies. It's not considered a replacement for condoms. The recommendation from the CDC is that PrEP is to be an addition to condoms for people in high risk categories.

The new federal guidelines recommend that PrEP be considered for people who are HIV-negative and at substantial risk for HIV.

For sexual transmission, this includes anyone who is in an ongoing relationship with an HIV-positive partner. It also includes anyone who 1) is not in a mutually monogamous relationship with a partner who recently tested HIV-negative, and 2) is a

• gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months; or
• heterosexual manor woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners).

For people who inject drugs, this includes those who have injected illicit drugs in the past 6 months and who have shared injection equipment or been in drug treatment for injection drug use in the past 6 months.

The latest U.S. numbers on STDs in men who have sex with men don't look good. Syphilis, hepatitis, gonorrhea, chlamydia and antibiotic resistance STDs increased when barebacking became the norm.

Gonorrhea Rates in MSM:

Syphilis Rates in MSM:

STD Rates in HIV- and HIV+ MSM:

Antibiotic Resistant STDs in MSM:

Let's substitute prEP for condoms.

If one restricts himself to having sex with people who [STRIKE]use condoms[/STRIKE] are taking prEP [STRIKE]and a condom breaks[/STRIKE], the chances of becoming infected are greatly reduced, exponentially reduced, compared to one who rarely practices safe sex.

The "strikethrough" is not wise for OP or any gay man. Condoms should still be used. In the case of OP, PrEP would not be recommended because he is not sexually active nor does he have a current partner who is HIV+ or in a high risk group.

 

[bankside]

The difference, though, is that we have nearly 30 years of evidence of risk reduction- not only in HIV but in all STDs- to support the conclusion that condoms work.

The latest U.S. numbers on STDs in men who have sex with men don't look good. Syphilis, hepatitis, gonorrhea, chlamydia and antibiotic resistance STDs increased when barebacking became the norm.

Syphilis Rates in MSM:

Kara, that chart seems to tell the story doesn't it?

Gays have been told to use condoms for 3 decades, and they do. More than straights. I wish this article gave me more original sources, but here's a starting point and I believe it.

http://rabble.ca/blogs/bloggers/ick...s-more-straight-people-why-do-they-get-infect

Studies show that gay guys consistently use condoms with casual sex partners at rates way higher than do heterosexuals. In one study conducted at Toronto Pride in 2006, 75-80% of gay guys reported consistent condom use with casual partners. And even if that number is inflated, it's still much higher than the rate for heterosexuals. Yet in Ottawa, gay guys still account for more new HIV infections than any other population and, in the US, gay men are the only group among whom HIV infections are currently on the rise.

If we're using condoms more than the average population and still seeing acceleration of various sexual infections more than the average population, then it has to be something else..

We have to tell gay people not to fuck everything that moves. People need to pace themselves.

 

[KaraBulut]

Kara, that chart seems to tell the story doesn't it?

Gays have been told to use condoms for 3 decades, and they do. More than straights. I wish this article gave me more original sources, but here's a starting point and I believe it.

http://rabble.ca/blogs/bloggers/ick...s-more-straight-people-why-do-they-get-infect

One problem with the way that HIV has been viewed demographically is that it overlooks some of the real reasons behind why certain groups are at higher risk.

It's not just that gay men use/don't use condoms. The underlying issue is that we are more likely to have anal sex which in the US has always been the primary source of new infections. Because of the obsession of certain religious groups with the sodomy issue (remember the "rugged vagina" nonsense?), we downplayed that aspect of HIV transmission.

There is another group of people who are showing an increase- IV drug users. Opiate addicts are finding it hard to obtain prescriptions from physicians, so this is causing an increase in the use of drugs obtained on the street and an increase in the sharing of needles.

If we're using condoms more than the average population and still seeing acceleration of various sexual infections more than the average population, then it has to be something else..

There's not one single cause of the increase.

This is from a recent CDC analysis:

After new HIV infections among men who have sex with men (MSM) peaked in the mid-1980s at more than 75,000 new infections a year, the number of new infections plummeted to less than 18,000 per year by the early 1990s. Unfortunately, after years of steady progress, new infections again began to rise among MSM throughout the 1990s. While in recent years, prevention efforts may have helped stabilize infections, they are occurring at far too high a level (29,800 per year.)8 Additionally, young MSM are the only risk group in which new infections are increasing. This underscores the need to sustain and re-invigorate prevention efforts for gay and bisexual men of every race and to ensure that each generation is effectively reached.

Part of the increase can be attributed to a generation of HIV+ people who died in the period 1980-1996 before effective antiretroviral treatment became available in the US. To be frank, when people died before they could infect others, the transmission rates declined.

But probably the biggest factor in the decline was that in the period from 1980-1996, there was a generation of gay men who knew someone who died of AIDS. Those deaths were often sudden and when they were not sudden, the friends of people with AIDS saw a painful, slow decline before their friends died. This personal experience with led to behavior modification and peer pressure that encouraged condom use, reduction in the number of partners, a trend toward dating/relationships and friends who kept friends from doing stupid things.

Ironically about the same time that treatments improved in the 90s, meth use increased in the gay community. Circuit parties that purported to support AIDS charities encouraged a party-and-play culture. Then came chat rooms, hookup websites, Grindr, Scruff and all the rest.

We're now 20 years past 1996 and there's a new generation of gay men who have never known someone who died of HIV-related causes. There's now a generation of gay men who have the freedom to live openly, the freedom to date in the way that their straight friends do and in some cases, the freedom to marry or adopt children. Twenty years after we developed effective antiretrovirals that changed HIV from a nearly 100% fatal condition to something that is more like other chronic conditions like diabetes.

The gay community is losing the history of what happened in the 1980s and the current generation of young gay men are returning to some of the reckless behaviors that led to the events from 1980-1996.

We have to tell gay people not to fuck everything that moves. People need to pace themselves.

We tried that in the 1980s. It didn't work. We're designed to fuck and fuck often. We're designed to want the press of flesh and the touch of another person.

What worked was behavior modification. Condoms use because the norm- in both real life and in porn films.

There's another thread in Hot Topics where a member commented that he was pressured by partners not to use condoms- as if it were an insult to his partner that he wanted to protect himself and his partner. As long as we have that attitude, the HIV infection rates will continue to increase.

 

[mbamike]

Statistics have been showing for years that unprotected sex is on the rise among young gay men. So, it make sense that STDs are on the rise also.

The fear of catching HIV no longer has the impact it once did and the attitude towards catching an STD is similar to catching a cold or flu. So, the gay community and the public health professionals need to re-think how it wants to define safer sex.

For me, that definition includes a daily dosage of Truvada aka prEP. As a Truvada user, I am "required" to get tested every three months for STDs and HIV. Also, I receive Truvada for FREE.

I know Truvada will do nothing in preventing an STD infection, but numerous studies have shown that it is highly effective in preventing HIV. Unlike an STD, HIV is for life.

So, it seems to me that if Truvada is made available for free to all sexually active MSM, a major HIV epidemic can be avoided.

 

[KaraBulut]

I know Truvada will do nothing in preventing an STD infection, but numerous studies have shown that it is highly effective in preventing HIV. Unlike an STD, HIV is for life.

There are numerous studies ongoing but the decision to approve Truvada for PrEP was made on surprisingly few studies and it was specifically stated that it was for certain high risk groups (e.g. discordant couples) and was not a replacement for condoms.

So, it seems to me that if Truvada is made available for free to all sexually active MSM, a major HIV epidemic can be avoided.

AZT was approved for mass use in 1987. HAART became the standard of care in 1996-1997. After 1997, incidence of resistant HIV dropped, morbidity and death rates dropped but the infection rates remained fairly constant after 1997- at least until the past couple of years. HAART results in lower viral loads and lower risk of infectiousness but it has not reduced infections significantly. Or in other words, our past experience with antiretroviral therapy is that it has impacted survival of those who have HIV infections but it has not reduced the number of new HIV infections.

Note on the graph below that the drop in HIV infection rates started in 1985 when death rates were still high and when condom use became the norm. Behavior modification (e.g. condom use, decreases in number of partners) in the late 1980s was very effective is lowering the rates of new infections.

(larger version)
PrEP isn't going to slow what is already happening. It's clear that we're on the cusp of another wave of HIV infections in US- particularly among MSM and minorities. The only difference is that we have better pharmaceutical options for long-term management.

 

[mbamike]

there are numerous studies ongoing but the decision to approve truvada for prep was made on surprisingly few studies and it was specifically stated that it was for certain high risk groups (e.g. Discordant couples) and was not a replacement for condoms.

The new federal guidelines recommend that PrEP be considered for people who are HIV-negative and at substantial risk for HIV.

For sexual transmission, this includes anyone who is in an ongoing relationship with an HIV-positive partner. It also includes anyone who
1) is not in a mutually monogamous* relationship with a partner who recently tested HIV-negative, and
2) is a gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months; or

heterosexual manor woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners).

SOURCE: Cdc. Gov

Seems to me there is a large number of bottoms and versatiles that qualify for prEP. Why shouldn't mass distribution of prEP be given to this group to avoid an HIV epidemic? What am i not understanding?

Azt was approved for mass use in 1987. Haart became the standard of care in 1996-1997. After 1997, incidence of resistant hiv dropped, morbidity and death rates dropped but the infection rates remained fairly constant after 1997- at least until the past couple of years. Haart results in lower viral loads and lower risk of infectiousness but it has not reduced infections significantly. Or in other words, our past experience with antiretroviral therapy is that it has impacted survival of those who have HIV infections but it has not reduced the number of new HIV infections.

Note on the graph below that the drop in hiv infection rates started in 1985 when death rates were still high and when condom use became the norm. Behavior modification (e.g. Condom use, decreases in number of partners) in the late 1980s was very effective is lowering the rates of new infections.

(larger version)
PrEP isn't going to slow what is already happening. It's clear that we're on the cusp of another wave of HIV infections in us- particularly among MSM and minorities. The only difference is that we have better pharmaceutical options for long-term management.

I am totally missing this one. Sorry!

I take Truvada everyday as a prEP. I understand it is 99% effective in preventing HIV (even without the use of condoms) when it is taken daily. What is the significance of the infection rates remaining constant?

 

[KaraBulut]

Seems to me there is a large number of bottoms and versatiles that qualify for prEP. Why shouldn't mass distribution of prEP be given to this group to avoid an HIV epidemic? What am i not understanding?

The primary problem is cost- the annual cost for Truvada is over $12K per year. Even with group insurance plans, it's generally in the top tier for deductibles/copays.

Not all gay men are in the same socioeconomic group. The group of MSM who have the highest rate of HIV infections is black and hispanic men in urban areas, many of whom can't afford PrEP (which is ridiculously expensive).

I understand it is 99% effective in preventing HIV (even without the use of condoms) when it is taken daily.

There's no study that supports "99% effective". The rates that are quoted in the media are studies of people having sex with partners of unknown status (the "russian roulette" method of public health studies).
http://www.healthline.com/health-news/studies-show-truvada-prevents-hiv-when-taken-as-needed-022415

The best studies that we had were studies of committed heterosexual and homosexual couples where we knew that one person had HIV and the other partner did not ("discordant couples"- the 2011 Partners PrEP study).

What no one has really disclosed to you is that you are part of an informal study. We aren't sure that PrEP will work- the studies have been limited. So, now that it is available to the general public, those who are being monitored (at places like the VA that have electronic records) will be the way we find out if it works.

What is the significance of the infection rates remaining constant?

Because if you put someone with HIV on HAART, their viral load drops to near zero which the studies show means that they are very unlikely to transmit HIV to their partners- even when they have unprotected sex.

HAART has been available for 15 years. If the HIV rates for the past 15 years have remained constant this means people with HIV a) aren't on HAART and b) they're still having unprotected sex and c) they're still having sex with multiple partners.

The only success that we have had in the past was with limited behavior modification (e.g. safer sex practices). However, MSM return to their old practices when there's no peer pressure to practice safer sex. We haven't been able to "medicate away" the HIV epidemic in the past. It's unlikely PrEP will make a difference either... assuming that it actually works and assuming that it doesn't just become an excuse to not use condoms (which was already happening before PrEP became available).

This is actually an old debate. In Larry Kramer's 1983 play "The Normal Heart", there's a discussion between Ned and his doctor about how to best stop the spread of HIV. We're still having the same debate 32 years later, only we know that there's no hope that gay men will change their behaviors in the long term:

NED. (jumping down and starting to dress) Needed? Needed for what? What is it exactly you're trying to get me to do?
EMMA. Tell gay men to stop having sex.
NED. What?
EMMA. Someone has to. Why not you?
NED. It is a preposterous request.
EMMA. It only sounds harsh. Wait a few more years, it won't sound so harsh.
NED. Do you realize that you are talking about millions of men who have singled out promiscuity to be their principal political agenda, the one they'd die before abandoning. How do you deal with that?
EMMA. Tell them they may die.
NED. You tell them!
EMMA. Are you saying you guys can't relate to each other in a nonsexual way?
NED. It's more complicated than that. For a lot of guys it's not easy to meet each other in any other way. It's a way of connecting — which becomes an addiction. And then they're caught in the web of peer pressure to perform and perform. Are you sure this is spread by having sex?
EMMA. Long before we isolated the hepatitis viruses we knew about the diseases they caused and how they got around. I think I'm right about this. I am seeing more cases each week than the week before. I figure that by the end of the year the number will be doubling every six months. That's something over a thousand cases by next June. Half of them will be dead. Your two friends I've just diagnosed? One of them will be dead. Maybe both of them.
NED. And you want me to tell every gay man in New York to stop having sex?
EMMA. Who said anything about just New York?
NED. You want me to tell every gay man across the country
EMMA. Across the world! That's the only way this disease will stop spreading.
NED. Dr. Brookner, isn't that just a tiny bit unrealistic?
EMMA. Mr. Weeks, if having sex can kill you, doesn't anybody with half a brain stop fucking? But perhaps you've never lost anything. Goodbye.

 

[hotatlboi]

There are numerous studies ongoing but the decision to approve Truvada for PrEP was made on surprisingly few studies and it was specifically stated that it was for certain high risk groups (e.g. discordant couples) and was not a replacement for condoms.

The evidence is pretty clear. In addition to the studies it has been in use for several years by quite a few so called "truvada whores" that partake in bareback sex with many partners. Few of those people have become HIV positive. I understand and fully agree that this behavior should be strongly cautioned against and it has caused a serious increase in non-HIV std infections among MSM. But trying to obfuscate the clear protection against HIV that it provides is absurd and will not win you any respect for doing your best against disease prevention.

AZT was approved for mass use in 1987. HAART became the standard of care in 1996-1997. After 1997, incidence of resistant HIV dropped, morbidity and death rates dropped but the infection rates remained fairly constant after 1997- at least until the past couple of years. HAART results in lower viral loads and lower risk of infectiousness but it has not reduced infections significantly. Or in other words, our past experience with antiretroviral therapy is that it has impacted survival of those who have HIV infections but it has not reduced the number of new HIV infections.

This has to be the most absurd comparison I have ever heard. Why would treatment of HIV with drugs be expected to reduce the overall rate of infections significantly when that treatment was only available to a small subset of the general population?

New infections were obviously among people NOT taking such therapy. So it says absolutely nothing about whether widespread use of Prep would reduce HIV infections among MSM.