bearbandit

The danger with using alcohol of any strength for an enema is not the level of intoxication that will result, but the possibility of shock. When drunk, alcohol is absorbed slowly into the system. When used as an enema it is absorbed directly into the bloodstream and it's entirely possible that someone's system will not be able to handle that level of I intoxication so quickly. As for HIV prevention, PrEP is the best solution, followed by importing your own generic truvada, followed by clinic hopping (claiming to barbarism sex and needing PEP). A wine enema isn't going to make any significant difference.

That's because rank is dependent on the number of posts you've made. Off the top of my head your rank changes after 25, 100, 500 and 1000 posts.

Thank you, as ever, fillmyholeftl, for the correction. Personal shit is taking up more time than I would like, leaving less time to keep ahead of the HIV news... My apologies for misinformation.

From what I understand there's far less documentation in this instance than in the other two, and I don't think anything is known about his adherence. There's a difference between extremely unlikely and impossible. But there's a whole load of rare events (like getting struck by lightning) that are more likely than seroconverting whilst being adherent to PrEP.

If it ain't broke, don't fix it! If he's undetectable, then the meds are working. Everybody's different in how they respond to meds, but I have to admit I've never heard of anyone going 20 years without a change in prescription. It might be an idea for him to talk to his HIV doctor about the possibility of changing, but if he's undetectable, he won't have enough of a viral load to test to see what would be the best combination for him (you need at least VL 1k and undetectable is between<20 and <70 depending on the lab). Also, if he's been on the same meds for so long they obviously must be fitting in well with his genetics so that he's having few in any side effects. There's no way of telling how long the same meds will continue to work for him: prediction and medicine do not make good bedfellows

From what I've read about this, the guy's virus has two specific mutations which make it resistant (but not totally resistant) to tenofovir. I've seen the list of drugs his virus is resistant to and it's about 10 (mostly, if not all, NRTIs and NNRTIs). Once analysed, we know which mutations will make HIV resistant to which drugs,so it's not a question of Gilead pulling their fingers out. It's important to remember that resistant/mutated virus is weaker than wildtype virus, and ultimately mutated virus is overtaken by wildtype virus, which is how come resistance fades over time and drugs can be re-used. While it's always been known that getting assfucked bare is the commonest infection route, it's always been known that the guy fucking can get it: how else do hundred percent hetero guys get it sexually from women? For this to happen twice in a year is still within the expected efficacy of truvada as PrEP. While on an individual level of course it's a bloody disaster, but on a total population level, it's unsurprising and truvada is as near to total protection as you can get. If I were neg and on PrEP I wouldn't be worried on a personal level: all manner of things are still more likely than seroconverting while on PrEP. apologies for any typos - writing this in bed and my tablet's dictionary isn't as versatile as the PC's...

AHF have persistently campaigned against PrEP: remember Weinstein calling it a "party drug"? I wouldn't trust anything that AHF has to say about PrEP (and am very glad that they're not a UK organisation!). What they keep failing to realise is that PrEP is part of an overall package towards curbing HIV transmission, and banging on about other STIs is a red herring. PrEP is designed to protect against one STI, namely HIV, and has no effect on other STIs. As rawfuckr mentions guys on PrEP are screened for STIs more frequently than most of the population, and if you look for things, you're liable to find them. It's perfectly possible to have an STI with no symptoms whatsoever, yet still be infectious. Gonorrhoea, for example doesn't necessarily present with a dripping cock: if the infection is in your ass, or your throat, it can be quite easily (if symptomatic) be dismissed as a bout of diarrhoea or a sore throat from "the bug that's going around". For all the importance that some people, and yes, AHF are amongst them, condoms don't necessarily protect against STIs: herpes, syphilis and others can easily be passed on by touch. If you can get PrEP, great. But even if you decide against PrEP, or it isn't available where you live, have regular STI checkups. Your fuckbuddies will thank you.

Thanks for the clarification there: I was meaning the sort of bone loss that constitutes osteopenia.

A regular STI check-up every three months, whether you're showing symptoms or not (about half the time men have no symptoms of an STI that they notice). More frequently if you're popular. And get vaccinated against Hepatitis A and B and HPV. As fillmyholeftl says, it's chance... I've only had three STIs in my life: hepatitis B, herpes and HIV.

Side effects of truvada are much commoner in people using it for treatment than prevention, except in one area: a few people find that their dreams can be somewhat intense. It's rare enough in poz people that my doctors insisted that the FTC (emtricitabine) in truvada couldn't possibly be the cause. Basically it was people on truvada-as-PrEP who convinced the doctors that this was real. Go figure! Apart from odd dreams (which only happens to a few) the commonest side effects are felt in the gut: a bit of nausea maybe, gas and loose stool, not enough to call diarrhoea. But most people get away with nothing at all. The thing to do is to experiment with the time of day you take it, with or without food, until you find out when your body's happy about it. But most people, probably 80% to 95% get away with no problems at all. If you do have problems try and work through them as they pass after a few weeks. The other problem with truvada is that the tenofovir can, in a very few people, cause a slight loss of bone tissue, but this is completely reversible simply by stopping taking the drug. About 1 in 10,000 poz people (a guess given my involvement in long term survivor groups, and that Fanconi's syndrome, a symptom of which is severe weakening of the bones occurs in about 1 in 100,000 poz people) will develop significant enough bone loss to require supplements, but this just hasn't been seen in HIV- people. Don't worry about long term use: the history of PrEP is six or more years old, which is a bloody long time in HIV terms, including all the trials and truvada is incredibly well tolerated. And within in a few years there's very likely to be another drug replacing truvada, I'm guessing cabotegravir, which from all my reading seems to be very promising. It's the drug that they're talking of being an injectable, so if it's approved for PrEP, it may be once a month or even once a quarter your get your PrEP injection. Don't worry: take the blue pill!

Thanks PozGoat - you've made my day. I know I'm apparently not around as much as I used to be, but that's because there's less need to intervene or comment. I don't drink alcohol or coffee, so I guess it'll have to be the cum

If he was poz, he's very likely to have been on successful treatment: recent trial results show that people with HIV who have an undetectable viral load (the goal of current therapy) are not infectious. End of worry. If he was poz and not on treatment, then his viral load could have been anywhere from a few thousand (about a thousand is the minimum viral load generally considered to be an infection risk, though there have been anecdotal reports of lower) to very high: depends on what stage of infection he was at. But generally I'd say this was pretty low risk. The tone of your messages suggests that you're very panicked about this and for that reason I'd suggest you go to an emergency room now and get medical advice. For there to have been any risk he'd have had to be poz and not on treatment, and you'd have noticed the pain when he rubbed the cum into your chest: cuts hurt when they're disturbed like that. But I have the feeling that you're not going to be satisfied with less than a medical opinion, which you can get, together with PEP (post exposure prophylaxis) from an emergency room. Note that PEP is only useful within 72 hours maximum, and better within 48 hours of the incident. While you're at the emergency room, I'd suggest that you ask about PrEP (pre-exposure prophylaxis) which, when taken properly will avoid all this panic. Finally, I ask you not to post essentially the same question in more than one forum: all it does is make you feel like you're doing more, but it irritates other people to the point where they're less likely to respond to you. Now, get yourself to a doctor...

Casual antibiotic use is a great way of ensuring that bacteria get practice in at becoming resistance to antibiotics. Truvada as PrEP works by ensuring that any HIV encountered is totally eliminated before it has a chance to establish an infection. Different bacteria are susceptible to different antibiotics. I once took six different antibiotics on holiday to the USA (during the HIV+ ban), each labelled with the symptoms of the disease they were to treat. an unsatisfactory approach, but the only viable one at the time. Regular STI check-ups and treatment when appropriate remain the best way to deal with STIs other than HIV (prophylaxis) Hep A/B and HPV (vaccination).

In the late 70s, pre-aids, I worked at London Gay Switchboard. Our health advice still stands today: many STIs don't necessarily show any symptoms, especially in the ass or the throat, and if they do show symptoms they can be ambiguous. So get checked regularly: the STI clinic is your friend. We used to recommend every three months, or more frequently if you're popular, or feel there's been a specific risk.