Tags:
• Opinion
• PrEP

17 Comments

1. Martin Says:
   

   Dude, seriously:

   1.) You are not a doctor, so don’t give medical advice.
   2.) You are not a psychologist, so don’t give psychological advice.
   3.) You are not a drama queen, so leave god out of it 😉

   Regarding 1.): People are different. Depending on your genetic code, it can take 5 months or 15 years for HIV to cause “serious medical problems”. Some people can handle medications very well, other can’t. For the former, PrEP seems to be the preferable option, for the latter not. You seem to be one of the lucky that are not very susceptible to HIV (if you haven’t been infected yet, likelyhood is that if you get infected you won’t develop serious symptoms within months like a friend of mine). So don’t pretend you’ve got all the answers. Because that would indeed be stupid.

   Regarding 2.): You say: “I’ve heard poz guy after poz guy say that becoming poz changed them for the better.” Yeah, well, that’s one half, probably a majority. The rest just vanishes. Having been prone to depression already, they use the HIV as an excuse to commit a drawn-out suicide by omission (i.e. not taking care of their health).

   Conclusion: Everybody should be presented with fact-based, sound information and afterwards be free to choose for himself. Instead of telling other people how to life their lives (what are we – Palin-adoring conservatives?) we should support our friends’ decisions no matter what. We should enjoy the fucking and not politicize it. The sex is great, but what makes life really worth living even during old age is basic human kindness.

2. tsch Says:
   

   I agree that it is rather odd, that they have this PrEP program now when they advocate safe sex, and if you aren’t willing to take the risk, then don’t take the risk. It is a good idea, but it is also a step in the wrong direction, and if safe sex advocating groups start to condone the PrEP program, I see it as a way of them giving in to barebackers. I don’t condone barebacking but I am certainly not against it, I too bareback, and I’m only 18, however I do take precautions, checking up on sexual partners history before barebacking, because I would like to stay negative, but I have looked at statistics and I do see a very little risk of contracting HIV at my age, especially since my sexual partners are my age too. Just my 2 cents.

3. Regular Guy Says:
   

   Rawtop: “Personally I think that PrEP is a product of guilt and fear. Guilt from having unprotected sex, and fear of HIV. It’s never smart to make decisions based on guilt or fear. You need to live a life where you don’t regret your decisions. If you’re going to bareback (especially if you’re bottoming), be honest with yourself and accept the risks.”

   That doesn’t make any sense. “If I can take some action to prevent something bad from happening to me, I shouldn’t do it because it means I’m really feeling guilty.” Ridiculous. HIV is most certainly a bad thing: it’s costly in terms of insurance, treatment is not a sure thing, and side effects of long term medications can be horrendous (thus, my friends take medication vacations). There’s no shame or guilt in not wanting to remain HIV negative. Under the circumstances, preventive medical action is good and frankly probably socially beneficial. If someone on my company’s insurance plan takes PrEP instead of going poz, that’s probably better for our premiums.

4. Adam Says:
   

   @Rawtop I still can’t figure out why some people read your blog. They clearly don’t get you and they are not a fan of yours.

   I’m not sure I can completely agree with you on your feelings on PrEP. There isn’t enough research and if people want to be guinea pigs for a drug that might one day evolve and cure or prevent HIV then good for them. I have been approached in the past to participate in some of these drug trials as I’m sure others have on this site. I haven’t bit the bullet yet but I might, not because I have guilt but because I would like there to someday be a cure. It might do me more harm than good, I don’t know but I’m willing to take a gamble for a good cause.

5. Martin Says:
   

   “Taking control of your own life and doing things like making decisions about your own body is at the heart of what this blog post is all about.”

   First of all, that’s what I’m saying. You on the other hand use phrases like:

   “Let me put this bluntly – you should…”
   “Don’t be stupid.”
   “And for god’s sake, don’t fuck up…”

   and my personal favorite:

   “That is how you should be living your life.”

   That is the same kind of pressuring rhetoric the Jerry Falwells of this world use. Maybe you don’t notice, because you speak from a place of anger (“Every time I brush my teeth…”).

   The truth is: It’s a gamble. If you (i.e. one) have the right genes and psychological stability, you (i.e. rawtop) might be right. If not – and I know quite a number of guys who progressed to AIDS rapidly, HIV or any other chronic disease can fuck you up big time. And we don’t know the outcome before we have taken the gamble. That makes pretty much all of us morons, patients and doctors alike. Just because your doctor is a fool doesn’t mean you yourself know any better, the only difference is that it’s your “god-given” right to decide over your body.

   You are right that all of us should learn to make good, informed decisions and then live with them (it’s more or less the secret to good karma and acheiving a zen state of mind). But it doesn’t mean that the decision you reached for yourself applies to even a single other person beside you.

   So make your point but tone down the pressure. Otherwise you’ll come across as overly agressive to hide the doubts you have about your own decision. So lay back, relax, fuck around and remember:

   EVERYBODY’S FREE TO WEAR SUNSCREEN!

6. Adam Says:
   

   Rawtop, I think you’re wrong on this one. People should make the choice they’re comfortable making. If you can’t enjoy sex without it being bareback, if you have disposable income to the tune of $2000/month and you want to take PrEP to avoid getting sick, then you should. If any of those things aren’t true, then PrEP isn’t a good option.

   People who take PrEP should definitely take the newer stuff (maybe Raltegravir and Truvada) that has fewer side effects. But if there’s an option out there that gives people the opportunity to have hot, bare sex without worry – then why NOT do that?

   Adam

7. Regular Guy Says:
   

   I’m with Martin. There’s a whole lot of preaching on rawtop.com. It may not come from the far right, but that doesn’t make it a different species.

8. sean Says:
   

   Why are bber’s who take PrEPs to reduce the risk of infection doing it out of guilt. If they had a vaccine, would those who got the shot be doing it because of guilt?

   In all likelyhood, PrEPss are somewhat effective in at least delaying infection – 2% is better than 0% but I think it’s likely to be much higher. I think there is a mind-set about using PrEPs that is similar to theories on how infectious poz guys are when they are on meds and have an undetectable viral load. It seems to me that doctors and authorities don’t want to run studies to prove/disprove this theory because they are afraid more men will bb. RT, even you have said, and I’m paraphrasing here, that you feel it is more risky to bb with a bber who doesn’t know his status vs. one on meds and with and undetectable viral load.

   Many talk about risks – I know the risks if I smoke, drink , party, drive without a seatbelt, ore bareback. Why is any different if some one chooses to take the risks of using PrEPs? Besides, wouldn’t the increase in in drug users help reduce the cost of drugs?

9. John Says:
   

   As a psychologist at an HIV/AIDS primary care clinic, I have to say that I have yet to come across a person with HIV/AIDS who feels that the diagnosis has changed him/her for the better. Such people are certainly the minority. That is the only part of this I wanted to reply to.

10. John Says:
    

    Adam,

    Just an aside, why not? A major reason is the many complications of these treatments, the long-term use of which can cause dementia, among other illnesses.

    Additionally, PREP is not a gaurantee that a person will not contract HIV.

    But, it is likely that PREP will build resistance to these treatments. Should a person on PREP contract HIV, the drugs he/she needs may no longer be effective.

11. John Says:
    

    RawTop, I wanted to reply to this as well. You said, “What I’m against is doctors illegally giving powerful, toxic medications for “off-label” uses like PrEP, and guys feeling so guilty about their sexual activities that they take those unproven meds without thinking about how they might harm them.”

    While I am not in favor of PrEP for a variety of reasons, this statement of yours is making two assumptions that I don’t think are founded. 1. Men who choose to utilize PrEP do so out of guilt for engaging in BB sex. If anything, this may be a projection of your own feelings. For some men who engage in high-risk behavior may not choose to use PrEP due to any guilt but of caution. 2. Many people who do choose PrEP think about how the medications may harm them. But, like you say, you have to weigh the risks, just as BB sex that can cause harm.

12. Adam Skinner Says:
    

    John,

    The mechanics of resistance aren’t that simple. Anyone who takes PrEP should practice appropriate adherence, and if they do, there’s very little risk that they would develop resistance.

    And, assuming you’re the same John, I certainly know that most HIV+ guys I know DO feel like it has changed us for the better (though of course we don’t want everyone to run out and get it!). I’d suggest that the majority of your sample set would OF COURSE feel otherwise, which is why they would seek your help in the first place. Would life be better without it? Sure. But having gone through it, I wouldn’t change it, which I never would have thought I’d say.

    Adam

13. Mr. X Says:
    

    PrEP is a bad idea because it will make more people become HIV+ instead of saving lives.

    Plus who knows what it will do to your body? HIV meds ARE NOT good for your body to begin with.

14. Tom Says:
    

    One of the things that is being noted in poz circles is how utterly misleading many of the arguments for PrEP have been, and how conspiratorial the whole thing is beginning to look. The science for PrEP is sloppy at best. The actual reduction of infections was only like 40%, basically worthless in terms of real world reductions, and an outright doomsday pill if it even slightly changes sexual behavior. Despite this, you’ll hear that the reduction in infections is “80%” or “92%” or “99%”. I’ve already seen some attempts at labeling PrEP “more effective than condoms”. These latter numbers have been achieved by deleting all the inconvenient people who didn’t take their PrEP “as directed”. This isn’t an honest depiction of the benefits to the drug though. Anyone who points this out is immediately shot down for opposing another option to reduce infections. This is done so reflexively and regularly that the phrase “another tool in our toolbelt” has come to be recognized as a pretty obvious sentence handed down by a specific drug company. For the record, the standard in all public health is that new options must be “non inferior” or likely to compliment existing measures. This is pretty common sense. You wouldn’t test airbags exclusively on people who don’t use seatbelts because the last thing you’d want to do is allow airbags to crowd out seatbelt usage. For some bizarre reason though, much of the HIV industry has fallen all over itself to talk about PrEP as an alternative for people who aren’t using condoms.

    We regularly have vaccine options that are 30% effective and can be used by everyone all the time, and we regularly throw these out for their lack of effectiveness. Vaccines are cheap, and have the distinct advantage of being universally accessible and used by everyone, all the time, regardless of their perception of risk. For some reason though, PrEP was on the front page of CNN with no less than the head of the NIH proclaiming it a breakthrough. What gives? Why would we dismiss vaccine options that are more likely to reduce infections in favor of a drug with unknown side effects and questionable benefits?

    The answer to the question is obvious to pretty much anyone who is willing to be honest about the state of the American medical system and specifically it’s relationship with people who are HIV+ or deemed to be at risk of acquiring HIV.

15. Shocker: I’m Thinking Of Going On PrEP! » rawTOP's Gay Bareback Sex Blog Says:
    

    […] and a half years ago when I first heard of PrEP I had an almost visceral negative reaction to it. I mean I really hated the idea on a number of levels. And when the issue came up on Breeding Zone […]

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