PrEP ? So, are YOU using it or not ??

[Nirish guy]

So, whilst having a coffee and chatting with a friend who also visits Thailand regularly and enjoys plenty of "company" whilst there, the topic of PrEP (Pre-exposure prophylaxis) came up as he was telling me he'd just sent away for his first supplies of the stuff and intends to start using it. Personally for several fairly vague reasons I haven't or hadn't ever bothered with it but have to admit at the start of each Asian trip I usually wish I HAD perhaps.

From the little I know about the subject the old issue about it having possible small but unwelcome side effects seems to be fairly sorted out now and any aliments seem to be quite minor now, but I'm aware there that here in the UK at least does still seem to be a bit of a stigma attached to taking PrEP and a certain amount of "slut shaming' still going on, the implication being if you're deciding to take it you're obviously just a big whore. Whereas in the likes of Australia it seems there is no stigma at all and in fact you're almost seen as having a cavalier attitude to your sexual health if you're NOT taking it.

So, just wondering, what's the boards habit, do more take it than not or are we all to set in our ways now that we feel we just don't need to now or are just happy taking the risk of the odd split condom every now and then ? I would stress that neither answer is the wrong one here, I'm merely wondering do more of us take it than not now or is it still the other way round perhaps ?

[cdnmatt]

I would love to answer, but I have absolutely no clue what PREP is. So I guess that's a no, I don't take it. :)

[Moses]

PrEP may fail https://www.poz.com/article/prep-fails-third-man-time-hiv-drug-resistance-blame

[Nirish guy]

I would love to answer, but I have absolutely no clue what PREP is. So I guess that's a no, I don't take it. :)

Really, wow, you HAVE been living in the sticks for too long it seems. PrEP IS ( basically) is tablet that has been out for a few years now and has recently been passed by Governments as safe to take etc which dramatically reduces the chances of you being infected with HIV during sex by more than 90% !!!

Aside from a few minor side effects that some people might experience such as mild diarrhoea etc ( and that's not everyone by far) it does seem a bit of a no brainer now that it's been passed as "safe", although being such a new drug there are still long term tests going on all around the world as to it's long term effects, but basically so far, it's doing exactly what it says on the tin and HIV rates ARE dropping as the virus simply isn't getting passed on as much.

There is a debate as to will it encourage less safe sex practices in people as they believe they're now protected from HIV ( but nothing else ) but still decide to stop using condoms ( thus leaving themselves open to all the other ranges of STI's out there, but NOT HIV at least, however the figures don't seem to be backing that up so much either as it seems ( as directed) most sensible people are using PrEP as intended i.e an additional part of the anti HIV armour and not as a total answer to "safe safe" and so ARE still using condoms ( as still being recommended of course.)

The above is just my rough answer re PrEP, so I've posted a link below which gives all the accurate data and explanation for those that are interested, but PrEP world wide is now being seen as a game changer in terms of blocking HIV transmission and I'm guessing it's going to be more and more widely used in the months and years ahead.

https://www.cdc.gov/hiv/basics/prep.html

[cdnmatt]

Oh, that's why I've never heard of it. I'm monogamous, plus I don't even like anal sex. No worries on this end. :)

[aot871]

In some cases its the cost of obtaing the drug,where its not free

[colmx]

Aside from a few minor side effects that some people might experience such as mild diarrhoea etc ( and that's not everyone by far)

You left out the minor side effect of potential kidney damage!
I know of 2 people that were taken off it after 3 months due to decreased kidney function... So its far from being mild in its side effects. I have also heard that the mild diarrhoea is closer to samlonella when it comes to the toilet department!

[latintopxxx]

colmx..is your real name by ay chance chicken little.

[Nirish guy]

As I said Colmx I wasn't suggesting I was in any way promoting or saying it was great, I don't take it, I don't know, I'm only going from what I've ready myself and that seems to have gone from quite bad side effects to lesser ones later on as people realised perhaps that it wasn't all plain sailing and what they might expect, of course any one thinking of taking it should do their own research, that goes without saying and was why I added the link. Saying that it seems that a LOT of guys ARE now taking it quite successfully too so I'm now quite sure where that leaves things, hence my original question about board members own experiences if they have any.

And latin Colmx's comments are bang on as well, there are instances of exactly what he is talking about, it's all well documented and a known "issue" for some people and it seems PrEP may not be for everyone, just up to each individual I guess as to whether it is adversely affecting them / their lives V the risk reduction and is that worth it depending what sort of risk they think they're placing themselves at I guess - and for some of us and what with it being Thailand etc that risk is unfortunately quite high these days.

[colmx]

with it being Thailand etc that risk is unfortunately quite high these days.

HIV infection rates are also on the rise in Ireland (Republic) but the government refuses to enter the PrEP debate. Unfortunately this leads to people buying it online and taking it without proper medical supervision.

Interesting stat is most new Irish infections are coming from people who were born in Latin America. And they are overtaking the native Irish HIV population
(Not a Dig at LatinTop... Just stating a fact!)

[Nirish guy]

........ most new Irish infections are coming from people who were born in Latin America. And they are overtaking the native Irish HIV population
.......Not a Dig at LatinTop... Just stating a fact!)

But if Carlsberg were digs then THAT would be a cracker :-)


"this leads to people buying it online and taking it without proper medical supervision".

And you're right about that too as already my friend who hasn't even received his in the post yet ( as he's buying it) is already talking about "well sure it means if I don't use a condom on the odd occasion" ( that was a NEVER broken rule before for him) and "ack well sure if I feel sick I'll only take it when I'm going away to Asia and for weekends and stuff" ( it SO doesn't work that way, even I know that and it must be taken religiously ( and I don't mean by priests there......although that probably be a fairly high risk group these days anyway)....so yes, without supervision and the proper education of it's requirements, definitely not a good thing.

[dorayme]

How can I buy it online?

[catawampuscat]

PrEP is used by gay/straight couples, where one is HIV positive and the other negative.
A significant secondary market is male and female sex workers and lastly those who are
not condom users.
The R.C. Church should love it and endorse its use as it's not a form of birth control..

[Nirish guy]

Catawampuscat - Im not sure if intentional on your part or not but you've left our single gay guys, who DO us condoms but want that extra layer of protection in case of condom breakages etc, there are quite a few of those guys using PrEP it seems too, which is a good use of PrEP and is as it's being recommended to be taken and is being taken in a very responsible way.

[frequent]

Oh, that's why I've never heard of it. I'm monogamous, plus I don't even like anal sex. No worries on this end. :)In your case then you're not worrying about your end?

[frequent]

The R.C. Church should love it and endorse its use as it's not a form of birth control..I didn't realise the Church condoned promiscuity these days

[Nirish guy]

I didn't realise the Church condoned promiscuity these days

No, only when it's priests being promiscuous with young boys and then it's all quite fine - apparently,

[scottish-guy]

Its generally available free on the NHS in Scotland.

As far as I understand it is simply the same concoction of drugs in a single pill that HIV sufferers take, so it is not expensive compared to the consequences/complications of contracting HIV.

Another thing I did not realise is that those living with HIV and under (and complying with) the current best treatment are completely uninfectious

[Nirish guy]

Another thing I did not realise is that those living with HIV and under (and complying with) the current best treatment are completely uninfectious

I think you're referring to those who have HIV but as they're successfully on tablets etc they have now reached a point of having an "undetectable" viral load, this means the chances of them being able to pass on HIV is very low ( but not impossible), likewise however there could be people who have HIV and are taking their tablets who either haven't reached that undetectable point or due to ill health or their medication not working as it should their viral load (i.e the amount of HIV in their blood / body) has increased again and so one should never just assume that if someone is on their meds that they are risk free, there's a chance that certainly is the case but it should never been taken as read and of course condoms ( and PrEP if you chose to ?) should be used at all times anyway to ensure the maximum levels of protection.

[frequent]

No, only when it's priests being promiscuous with young boys and then it's all quite fine - apparently,Everyone has to have a hobby

[Maxxy]

Not taking it yet, all my anal sex is done with condoms whether or not I top or bottom, I am planning at some stage to spend 3 to 6 months in Thailand and if that eventuates I would seek out the clinic that prescribes prep and would start using it under proper medical supervision. This would be as an extra level of protection in conjunction with the condoms. Oral is done bare so maybe the prep would be of benefit there too even though they say infection via oral is minimal I would like to make it even more minimal

[RonanTheBarbarian]

Interesting graph there colmx,

I didn't realise that the demographics of HIV were changing so much in Ireland.

I wonder what are the factors when you dig down. The majority of Latin Americans in Ireland are Brazilians, usually here for a short enough time.

Did they acquire HIV in Ireland, or did they get it elsewhere and it was only diagnosed here?

Given that the gay male Irish born population must be (at a conservative estimate) 60 times that of the gay male Brazilian population (and even that assumes that 10% of the Brazilians are gay compared to 4% of the Irish, which isn't likely, but you never know- going by the denizens of Dublin gay bars, there definitely seem to be a lot of Latin American gays)I would strongly suspect that they came to Ireland already infected.

As for PrEP, it sounds like a wonder drug, but it must be a powerful one - I wonder could there be undetected sde-effecst to taking it for years and years?

Still, if you feel that you might partake in unsafe sex in the immediate future, it is the better option than putting yourself of HIV, I suppose.

[Mickp]

Im surprised not to see any of the money boy profile's s on Pattaya GRomeo advertising they are on PrEPand can be barebacked!
Mind you it will eventually happen.
I guess its lack of money for the treatment

Being a bottom , I dont like the feeling of condoms,I may consider PrEP im still thinkiing about it at this stage.

[kittyboy]

I just got back from 4 weeks in Thailand. 2 weeks in BKK and 2 weeks in Pattaya.
I came of age during the AIDS epidemic and went to quite a few funerals. I was shocked at the attitude in BKK. I met 5-6 guys on Grindr and at 2 of them were insistent that I bareback them. They assured me they were on PREP and that there was no problem. I declined and one guy basically said..ok I will go back on Grindr and find someone to fuck me raw.

Another guy said condoms were optional. I think that attitude is crazy. PREP is about 92% effective when the drug regime is properly followed. Even with modern drug treatments 1/3 of all HIV infected people die of HIV related diseases...a very nasty way to die.

For me the risk is not worth it.
There are also other STDs. UGh..

[christianpfc]

No.

I think it's a scam. Why would I (or the public via health insurance, or whoever, someone has to pay for it) pay for something that has side effects, is not 100% safe, and prevents only one disease, whereas condoms are much cheaper, have no side effect, close to 100% safe, and prevent not just Aids, but various other STDs and pregnancies as well? And you only take it (condom) when you need it, and you use it only as long as you need it.

I think PrEP is wrong. It gives people the sense of security, where there is none. The effort of developing PrEP and advertising it is all misguided, that money should have gone into other research where it would be more effective.

(I have little knowledge about PrEP or medicine, but as a chemist I understand science, and you can bombard me with statistics that proof the opposite of what I claimed above, I will still not believe or take PrEP. - A comparison is a Thai boy who once wanted to borrow 5000 THB and explained a detailed scheme when and how he will pay back the money, all in vain, I didn't lent him any!)

[frequent]

I think it's a scam. Why would I (or the public via health insurance, or whoever, someone has to pay for it) pay for something that has side effects, is not 100% safe, and prevents only one disease ...I think you'll find there's a large number of prescription-only drugs available publicly or via health insurance that meet those criteria

[justaguy]

I think you're referring to those who have HIV but as they're successfully on tablets etc they have now reached a point of having an "undetectable" viral load, this means the chances of them being able to pass on HIV is very low ( but not impossible), likewise however there could be people who have HIV and are taking their tablets who either haven't reached that undetectable point or due to ill health or their medication not working as it should their viral load (i.e the amount of HIV in their blood / body) has increased again and so one should never just assume that if someone is on their meds that they are risk free, there's a chance that certainly is the case but it should never been taken as read and of course condoms ( and PrEP if you chose to ?) should be used at all times anyway to ensure the maximum levels of protection.

The chance of a HIV positive person that has an undetectable viral load to infect another person is believed to be pretty small. I am somewhat surprised at the number of guys in Thailand that don't seem to be worried about this stuff to be pretty high. Last holiday I had sex with three other guys (apart from my boyfriend) and in all three cases the subject of using condoms has not entered into the conversation. They all let me fuck them without requesting me to use a condom..

In any case, I am HIV - but I know several people that are HIV +, these people are monitored in the western world at least, up to the point where in the early stages they return for cd4 tests every two to three months. The viral load becomes undetectable within about 5 to 6 months in most cases.

In any case, I do not believe that these pills contain the same stuff as HIV + people take, that to me does not make any sense, Atripla and Nevaparine, a popular HIV 'cocktail' works to rebuild CD4 levels (or maybe to reduce viral load achieving the effect of rebuilding CD4 levels) , effective making HIV undetectable, however I fail to see how it could prevent infection.

[christianpfc]

I think you'll find there's a large number of prescription-only drugs available publicly or via health insurance that meet those criteria
However for these drugs there is no alternative. My point is that there is an alternative to PrEP: the condom which is cheaper, safer, and protects against other diseases and pregnancy as well.

[justaguy]

However for these drugs there is no alternative. My point is that there is an alternative to PrEP: the condom which is cheaper, safer, and protects against other diseases and pregnancy as well.

Considering the target audience of this thread, pregnancy is one thing to not worry about :D

[goji]

If this prep stuff had zero side effects & looked safe long term, I could see the attraction.

Considering it does have side effects and there are questions about kidney damage, I think I'll carry on with condoms.

[fedssocr]

of course HIV isn't your only worry these days. The antibiotic resistant gonorrhea is apparently a huge issue around the world. And it's spreading thanks to oral sex as much as anal or vaginal sex. And of course PrEP will have no effect there either.
http://www.bbc.com/news/health-40520125?