GermanFucker

What would be the point? Seriously, I don't get it. Being on PrEP while saying you aren't means that others are not able to infect you and you also pose less of a risk to others. You cannot get sued for either. So the point is ethically and legally moot. One could say lying is always a douche move. Speaking from experience guys that feel the need to pretend to be something they are not are usually subpar fucks. Why choose to be inauthentic instead of standing by your guts.

I am not a teenage girl, so no.

Believe me, when it comes to fucking, I am very much at peace. I achieved that kind of sexual Zen, when i stopped dividing others into "superior" and "lesser" men.... yikes (another reason why our personalities are very much incompatible). There is nothing more liberating than not trying to have the sex you should have and instead simply enjoy the sex you actually like. Isn't that what barebacking was about originally? All I care for are indeed interesting experiences. Interesting to me can be because of the skill level of the other (I still remember barebacking that professional ballet dancer as a teenager some twenty years ago... talk about ass muscles), but also the other ones's character or the overall adventurousness or whimsy of the situation. But that's just me. There frankly is no point in trying to prove me wrong or espouse the superiority of your outlook on life. My contribution was simply to elucidate it what I like - no judgement, no claim to relevance when it comes to others. (As an aside: Alas, as a non-native speaker I only have a very cursory knowledge of English poetry, Whitman and the bard, sure, Browning not so much.)

In all honesty, we propably wouldn't "click", you're right about that. As to (2) business transaction was meant figuratively in the sense of supply meeting demand. There is a certain inevitability to the outcome. And I freely admit I am all ego. There is a thrill to the chase and the more elusive the prey, the more interesting the game. And what is wrong with goofy? I know perfect. I've had perfect. I've fucked the guys on the covers of gay magazines and you will find international porn stars in my list of contacts on my phone. I've had stunning group scenes with achingly beautiful guys full of athleticism and expert craftsmanship. And as i said before I do enjoy that as well. And maybe you can call me sexually jaded, if you want to. But I have so much impeccable sex that I actually enjoy the goofy, the awkward. Like the hispanic who couldn't quite take my large dick because I was the first guy after 5 years in a relationship with a woman. Or the young dom football player who earns a little extra on the side as an BDSM master, who just shot me a message because he thought my online profile came across as an "arrogant idiot". That was a glorious evening of talking, me sucking him, and yes, in the end he took my load, even though he hadn't planned to.

You should read the entirety of what I wrote. The second sentence says that I know some great bottoms that - given the right circumstances - i fuck regularly. And of course I was being provocative and cocky. But nowhere did I even allude to being entitled to every bottom's ass or that all bottoms are push-overs. I was just talking about a sense of comradery. Like when you take a bro to a bareback party, watch him fuck twenty guys and then blow the last load of the night in his ass afterwards.

LOL ... those were events for twentysomethings. As someone (ever so slightly 😉 ) over 35 I could go to those parties, because I'm a total top. As a bottom you'd have to be 18-early 30s maximum, but by that age you better be a vers. bottom.

Fantasy? I had the exact same thing dozens of times over the last 2-3 years.. got the videos to prove it, too (but will never show them to outsiders who are not part of our circle of friends). Anyway, I'm a total 9 or 10.

I did not say you did. I was referring to your example that there are plenty of other kinds of idiocy. My point was exactly that one should be allowed to point out the idiocy while at the same time not passing moral judgement. I have seen some guys in the last weeks who just seemed to have been waiting for the chance to finally be on the "right" side of a societal mob mentality directed against "dirty whores". Mine was a general observation that guys like these are "covidiots" not because they are sex-crazed lunatics, but because of their nasty attitude, the same kind of nasty attitude one can find in grocery stores as well.

I think that's the most important aspect when it comes to such incidents: Idiot-shaming might be warranted but we shouldn't start slut-shaming. It's not the sex that was the problem, it's not limiting contacts. They could have been playing monopoly and it would have been just as bad. Church choir practice is probably more risky than quickly bending over and taking a load. You shouldn't have sex not because sex is bad, but because minimizing contacts is good. You also shouldn't visit your sister for dinner. Over the last weeks I have seen proud barebackers turn into the morality police when it comes to CoVid-19, getting preachy and insulting others. I just don't believe that this will achieve anything. Men are idiots, twice so when it comes to sex. IMHO the best way is to compassionately explain, that this is not like AIDS during the 90s, in that A.) you can also pass it on to your Grandmother, B.) your friend's cancer might go from operable to inoperable because of limited hospital capacity, and most importantly C.) this will all be over much quicker, if everyone is doing his part in social distancing.

if you go to a pharmacy that specializes on HIV patients, you can also get a prescription for the Hexal variant, which is only 40 Euros. Both are quality generics made in germany, only difference is that the cheaper Hexal variant is only available in a limited number of pharmacies, whereas you can get the ratiopharm variant everywhere. in both cases any prescription by a licensed doctor will do, as this is price doesn't include rebates or is only available after insurance co-pay. it is indeed the official retail price for prep everyone pays, whether you have german insurance or not.

Maker of generics "Hexal" has lowered its prices for a 28-day prescription of Emtricitabin/Tenofovir available through a network of 79 big-city pharmacies to 40 Euros (or roughly 43,50 per full month). For those who don't have access to one of these pharmacies, there is also a 90-day supply of Emtricitabin/Tenofovir available from "Ratiopharm" for 199,90 Euros (or roughly 67,50 Euros per month). The difference here: Not only is this prescription available through all licenced pharmacies in the country (including mail order), but can also be used as part of HIV therapy for poz guys. Again: These are first-world, high income country FINAL prices, WITHOUT any health-insurance or drug-maker co-pay schemes (given that PrEP has gotten so cheap, public health insurances are probably going to cover it anyway from next year on, but even without that PrEP has now become financially bearable even if you are young and / or earning low wages). So all you need is a prescription from a doctor. The difference to sometimes much higher prices in the US: Patent expiration is take seriously here (very hard to sneak in an extension) and there is a competitive market for generics.

The problem with Atripla lies in the Efavirenz (a.k.a. Sustiva), which is know for its psychological and neurological side effects. That's why Atripla isn't used as a first-line treatment as much as it was years ago. There are newer, better "one pill a day" regimens out there with less side effects for a larger number of patients. Which is not to say that Atripla per se is bad. If it works for you, why change a working therapy? Everybody is different. However, Truvada (i.e. emtricitabine/tenofovir, the remaining two components of Atripla) alone is not necessarily commonly known for its psychoactive properties. I have had some problems with diarrhea and abdominal pain, that's why I take PrEP in the evening before going to bed. No weird dreams at all, but much less of an upset colon.

Given recent studies about the effectiveness of even PreP on demand, this should be a safe course of action.

To the best of my knowledge: Hep D is a coinfection (i.e. you get infected with Hep D at the same time as Hep B ) or superinfection (you already have chronic Hep B and acquire Hep D on top) that only occurs in connection with Hepatitis B. Successful vaccination against Hep B thusly means that you don't have to worry about Hep D. Hep E also usually doesn't become chronic in patients with a working immune system, though the acute phase can be severe. So if you don't want to worry about Hepatitis, as a Westerner this means: 1.) Get vaccinated against Hep A + Hep B. You're protected against Hep D as well. 2.) Talk to your doctor about your risks and options regarding Hep E if you are travelling / working a in region where it's rampant (parts of Africa / Asia). 3.) Know about the risk factors when it comes to Hep C, especially when you are into violent fisting etc., IV drugs etc. 4.) Know that today Hep C is curable in most cases, but threatment can either be grueling (depression, fatigue, nausea with the classical treatment options) or insanely expensive with new options like Sofosbuvir (I've heard prices between 40,000 Euros in the EU and 90.000 Dollars in the US for a typical course of treatment). 5.) Know which risks you are willing to take and adjust your behaviour accordingly. 6.) Relax. 7.) FUCK

First of all: A majority of cases of HepC were already treatable / curable with the old medication. But that was often a 6-12 months horrorshow of therapy (especially due to the interferon) with a likelihood - depending on the genotype of the virus - of often more than 20% that the therapy was not successful. With Sofosbuvir it is only 3 months in most cases (i.e. half the time), far fewer side effects and a success rate much closer to 100% on the first try. Cases of chronic Hep B are more seldom, but do exist. They are, however, other than HepC, completely preventable: Simply by getting VACCINATED.

Correct. Antiretroviral therapy for HIV-positive patients usually consists of three or more components, i.e. three different classes of antiretroviral drugs (e.g. NRTI + NNRTI + NtRTI ). Simply speaking this way combination therapy has the virus effectively "cornered", leaving no viable direction in which to mutate. If you only have one or two active ingredients (like in the case of truvada: tenofovir disoproxil fumarate + emtricitabine), the virus will develop resistance much easier and faster (some remember the hight of the AIDS epidemic where an AZT / zidovudine monotherapy could only hold off AIDS for so long). If for some reason you should get infected (e.g. because the medication you bought over the internet did not contain the necessary amounts of active ingredient to be effective, or simply because you forgot to take you PrEP regularly during the time periods when you were sexually active), it is imperative that your doctor changes your medication regime to be effective as a therapy. This might just mean adding a second pill or changing to a one-pill-per-day-regime which also contains tenofovir disoproxil fumarate + emtricitabine. Or it could mean switching meds completely, because your virus is already resistant to either tenofovir disoproxil fumarate or emtricitabine. Think of it this way: PrEP is for sex pigs. If you have sex with strangers only twice a year and don't mind using condoms, use condoms. Guys who consider PrEP know why they need PrEP. And if you know you need PrEP, you have sex often and adventurously enough to warrant 4 trips to the doctor per year. That way you can also get your regular check-ups for gono, syph etc.. And if you don't want to use your regular doctor, you will certainly find an excuse to drive 100 miles to the next big city to visit a specialist there, if it is only four times a year. Call it a fishing trip or whatever ;).

That's always the best advise. But the mechanism of action of the active substances in truvada is well documented public knowledge, so everybody can double check what is said here. Tenofovir is a Nucleotide analog reverse-transcriptase inhibitors (NtARTI or NtRTI). Emtricitabine is a Nucleoside analog reverse-transcriptase inhibitors (NARTI or NRTI). Both prevent the HIV virus from integrating its DNA into the T-Cells in your mucosal tissues and bloods stream, and by extension, reaching the dormant parts of you immune system and building reservoirs there (the reason why undetectable poz guys unfortunately are not fully cured of the virus). So in short: yes, PreP should provide sufficient protection, even if the skin or mucosal tissue is damaged, given that: a.) it is taken regularly enough according to prescription b.) the specific virus the is not resistant against Tenofovir or Emtricitabine. You still are, however at risk for other infections such as syphillis. But then again, not taking PreP because it is just 99.99% safe instead of 100% doesn't make much sense.

307, but you have to keep in mind that I'm not vers. So being a top I miss out on half the points

If you read the medical recommendations in detail you will find that undetectable with a supressed viral load OVER A PROLONGED PERIOD OF TIME is considered safe / untransmittable. It is a well known fact that HIV viral load in blood / semen / mucosal tissue etc. decreases (increases) at a different rate once you start (stop) treatment. A supressed viral load in your blood over a prolonged period of time serves as an indicator that there is also little virus in other bodily tissues / fluids. Of course having just started meds is safer than having completely untreated HIV, just as taking PrEP intermittendly is better than not at all. It is still worthwhile to read up on the issue than just to go by word of mouth / what is touted by some. There is hard data for those who have been taking their meds over a prolonged period of time, that is why for THIS GROUP one can confidently make recommendations. But if you fall outside known parameters, everything is just a - more or less - educated guess.

To the best of my knowlegde your doctor's recommendation is scientifically sound - meaning that 7 days sounds like a good timeframe for a reasoble level of active substance (i.e. both emtricitabine AND tenofovir) to build up in your system (bloodstream, different types of mucosal tissue etc.). So your idea is certainly not outrageously unrealistic. But neither is leaker's recommendation to just go with one pill a day. The thing is: your suggestion is certainly better than no PrEP at all and most likely much better than intermittent 2-1-1 PrEP on demand. Whether it is AS good (for you) as daily PrEP realistically is a question you can only answer yourself. E.g. from personal experience: Adherence is not a problem for me, but I have a - let's say: interesting - circle of friends. Things can happen spontaneously. A twosome can escalate into a two-day fuckfest with 30 guys. Not having to plan my periods of sexual activity in advance is giving me peace of mind.

Most guys understand "on demand" as two pills the day before sex, one pill per day for two days after sex. The problem with that seems to be that at least one of the active substances in Truvada doesn't have enough time to build a sufficent level in the mucosal tissues, thus offering not exactly the same level of protection as daily PrEP. Taking PrEP for seven days before sex should be somewhat better, but a.) this is question for a specialist and b.) general probabilities can not really 100% predict what is right FOR YOU. While the data concerning daily PrEP is very sound, when it comes to intermittend PrEP it is somewhat fuzzy, as many understand it differently and medication adherence varies. E.g.: Daily PrEP is a safety net, if your adherence is rather average than exceptional. If you forget a dose, you still have enough active substance in your system. This is not the case with the 2+1+1 approach. I know guys who took PrEP on demand, but not diligently and who got pozzed because of that. As to drug resistance: HIV can only get resistant, if you are infected AND on insufficient treatment. That is why HIV testing is an important part of taking PrEP. If you for example got infected because you forgot to take it regularly, Truvada alone would be insufficient treatment, your meds regime would have to be altered in order to avoide resistance. If you take PrEP diligently enough to avoid infection, there is no HIV in your system that could develop a resistance.

Yeah, I'm kinda surprised that many guys here say their first contact was with another person. I thought most of the guys here would answer the same, something along the lines of "age 15, under the shower, pissing in my own mouth and on my chest".

P.S.: To sort out the confusion regarding HepC: With new treatment options like Sofosbuvir, Hepatitis C cure rates have vastly improved. Where before you might have had to undergo half a year of a grueling med regimen including interferon to have a 50% chance of being cured, it is now more than 90% in half the time. But it still depends on the (geno-) type of Hepatitis C. So both sides are true. With the new drugs that have become available over the last 5 years HepC treatment has greatly improved for the vast majority. Some people battling HepC for for decades have finally been able get rid of it. However there are still some types of Hepatitis C that are more tricky / resistant to Sofosbuvir. Also some might still die because of existing liver damage suffered before the new options became availabe. (too late for edit, moderators feel free to merge posts)

I really appreciate the difference between a well-informed, fact-based statement like this "One of the long term side effects of Truvada is bone density loss after years of use, ...." as compared to "Westerner people specially US people listen to a lot of rubbish with false stats because it's all about money." I think we should be honest and realize that PrEP is one additional option as a prevention tool, is not a replacement for condoms, it's not a panacea and it actually isn't for everyone. If you have two (tested) neg guys in a relationship, where they fuck around outside their relationship once a month or so and they use condoms doing so (because they don't want to give their partner one of the things that Truvada can't prevent like gonorrhea), the risk of contracting HIV due to condom failure is negligible. In that case PrEP is probably not worth the potential long-term side effects and it is not a cost-effective solution, either. There are studies (Australia etc.) as to that point. Truvada is a potent medication and for some it can (but not necessarily must) stress the kidney and bones after long-term use (the vast majority will have no problems, however). But Truvada PrEP a good solution for men at a high risk of becoming infected. In that case the equation is clear: The benefits of not contracting HIV far outweigh potential side effects. As do the cost savings of PrEP vs. HIV treatment, at least in the case of Truvada (unfortunately not for new drugs like Descovy), where the patent has expired or is just about to (depending on your country). Because you have to keep in mind that the officially listed prices are not the "real" prices it costs to make the drugs or that Truvada is traded for between manufacturers and insurance companies. Here in Germany, health insurance will not cover the cost of PrEP. But due to a special arrangement between Pharmacies specializing on HIV patients and a maker of generics (Hexal AG, a subsidiary of Novartis), instead of paying the catalog price, you can get it for the same price that health insurance companies pay for it after rebates. Which is 50 Euros a month or 1.79 Euros per pill / day, i.e. $60 / $2.15 at current exchange rates. And these are first world, high income country prices. If would of course be much, much cheaper to manufacture the pills in India. Still, because of the - low, but existant - risk of side effects and the necessity to make sure that the person is acutally HIV negative before prescribing what would otherwise be bad, insufficient HIV therapy, it is best to go through the proper channels and have a doctor monitor you bloodwork (kidney etc.) regularly, instead of just getting a Truvada clone from India over the internet. In short: Truvada PrEP isn't necessarily the most sensible choice for everyone. Probably not even for the majority of gay men. But it is a great choice for sluts, sex pigs and unrepentent barebackers of all strides. So the vast majority of men on this site (except for the bug chasers and HIV fetishists, but that's ok).