Damn, the last month or two have been brutal – especially the last few weeks, but I’m starting to see the light at the end of the tunnel. My apologies for being a bit neglectful of the site, but the last few weeks it’s felt like there are always 3 high priority things that have to get done and if I worked really really hard I might be able to get 2 of them done. There has been zero spare time, or more accurately what little spare time I have has been spent collapsed out of exhaustion on the couch.

Needless to say there hasn’t been enough energy to hookup with anyone. I see that changing in the near future. This past week has generally been pretty good and I’m starting to catch up on all the things that got deferred. I’m starting to feel human again, but I’m still not back on top of everything.

All the pain has been a bit self-inflicted, however. When I first started drafting this a week ago I started writing up exactly what’s been going on, then I realized there was a bit too much personal information in what I was writing. I’ll tell you guys what’s been going on when it’s not a liability for me to say it. For now suffice it to say my boyfriend and I are working on a project that could be quite profitable and will make a big difference in our lives if everything goes well.

At the same time the project has been so intensive we’ve both had short fuses and there have been times when I wondered if I wouldn’t be happier if I were single. But in hindsight if I take out the stress of the situation my boyfriend has actually been really wonderful. If anything I’ve been more difficult to live with than he has. I’ve been a moody, bitchy mess. If I learned anything through all of this it’s that he’s 100% committed to the relationship and to me. That’s worth a lot.

The reporters at The Onion discuss the unrealistic views of sex that are promulgated by a sex-positive porn industry and how they affect kids’ views on sex…

A new study in The New England Journal of Medicine says starting HIV meds early reduces your chance of death. People who started their meds when their CD4+ count was in the range 351 to 500 had a death rate of 1.6 deaths per 100 person years while people who started their meds when their CD4+ count was over 500 had a death rate of 1.3 deaths per 100 person years. Since it’s from the New England Journal of Medicine I’ll assume all of their assumptions are reasonable and the research methodology is as good as it gets.

When you read some of the articles that discuss the findings of the study it’s really a balance between drug toxicity over decades and staying alive.

“It must still be recognized that the long-term side effects of the anti-HIV drugs we now use are unknown, and could alter this recommendation after longer patient follow-up,” said Dr. Jeffrey Laurence, a professor of medicine at Weill Cornell Medical College in New York City.

That I think is the one possible weakness in the study – they studied people between 1996 and 2005 – so basically a decade’s worth of data. If a kid goes on the drugs at the age of 20 he’s got 60 years of taking drugs if he wants to live to 80. The study states:

Starting therapy at progressively higher CD4+ counts has been shown to lower the risk of some toxic effects associated with antiretroviral therapy, including peripheral neuropathy, anemia, and renal insufficiency. However, all the potential side effects of long-term antiretroviral therapy are unknown.

In other words, no one can tell you they know what the side effects of the drugs will be after taking them for 60 years…

While this study does give some strong evidence, it (combined with the other studies already done) leave some questions unanswered. In the end it’s a personal decision and everyone should do the research and make their own decisions… It’s your body and your life – you’re the only one that’s responsible for it.

Just saw a story on The Sword that there’s a club drug mix out there now called MTV that combines Meth, Tenofivir (and anti-retroviral) and Viagra that neg barebackers are taking when they spend the night partying and barebacking… Meth to get high, Viagra to stay hard, and Tenofivir as a form of “PrEP”.

In case you don’t know anything about PrEP it’s an offshoot of PEP. PEP is the course of HIV meds that you take after being exposed to HIV. Used sparingly PEP is a good thing (though it’s a bit of a joke if you’re a bottom who regularly takes anonymous loads). PrEP takes that a step further an instead of being post-exposure it’s pre-exposure… If you’re the type of person who takes a lot of risk, you theoretically take HIV meds just like poz guys do so you won’t get HIV.

Let me put this bluntly – while you can make whatever choice you want, personally I think PrEP is a crock of shit and I’d never take it – even if I was a bottom. While the ARVs are far better today than they were 10 years ago, they still can have some serious side effects. It’s possible that the PrEP you take today could have worse long-term impacts than becoming HIV positive.

IMHO, the fewer meds I take the better. In the past I always said if I became poz I wouldn’t take meds until I clearly needed them. Now I’m not sure what I’d do. I might take a mild ARV, but I’d first want to get a sense for what HIV was doing in my body. If I could stay off meds I would – for example if it was clear that the strain I had was particularly mild.

One of my big issues is that doctors are putting people on ARVs immediately after diagnosis. They say it’s because it’s best for the patient, but I really think it’s because the meds stop them the person from spreading HIV. It’s clearly best for the community, but I don’t quite believe them that it’s best for the individual patient. [And yes, this is where my selfish American side comes out. A European would likely have no problem taking meds because it’s in the best interest of the community.]

The other problem with PrEP is that you can build up a resistence to ARVs and when you do become poz your treatment options are less. That’s not a good thing at all.

In the case of guys who take MTV or other forms of unsupervised, recreational PrEP they’re in an even worse position – their intermittent use of ARVs will most definitely create drug resistance problems for them long-term. And the combination of PNP and barebacking means they’ll probably wind up poz at which point the drug resistance will be a problem.

Bottom line – if you PNP leave ARVs out of the mix. In the long run you’re better off not taking ARVs until you need them. If you really want to be on PrEP – see a doctor and do exactly what s/he tells you to do (and be honest with them about your recreational drug use)…

I want my MTV too – the old one that played music videos all day long…

UPDATE: After realizing I could get around pretty well in Chicago with trains, I’ve decided to fly… If you’re looking for the train info, see my comment below.

I’m trying to figure out whether I should drive to IML this year like I did last year, or fly. The advantage of driving is having a car available when I get there to go to bars, bathhouses, etc. If I drive I’ll stop each way in Cleveland and use the Flex bathhouse as a hotel for the night, like I did last time. It does extend the trip ’cause it’s a two day drive in each direction, but it’s not a bad drive – there’s a lot of beautiful country between here and Chicago.

So the question is whether there’s anyone who might be looking for a ride to IML from the New York metro area? The only cost would be a tank of gas in each direction, the cost of the room at Flex Cleveland (about $40/night), plus a little time to go out for drinks ahead of time to make sure we want to spend that many hours together in a car. And by the way – I’m fine with taking two guys if it’s you and a buddy/boyfriend.

If you’re interested, e-mail me (rawtop@yahoo.com).

In the news is that an Australian researcher has come out and discussed the fact that HIV is becoming less deadly and eventually most likely won’t even be lethal or debilitating. This is something I’ve been saying on here for a while now – HIV, on average, is a lot less lethal than it used to be and the trend will continue. It’s a pretty simple fact that a virus that kills its host quickly will not spread as well as a virus that takes a long time to kill its host (or one doesn’t kill the host at all). The researcher is taking a very long term view with that trend and saying that eventually (if humans survive that long) the virus will be so weak or we’ll have adapted to the virus that it won’t bother us at all…