bearbandit

If someone is taking meds as prescribed, they should be undetectable within weeks, though the recommendation for TasP is six months of being undetectable. Be aware also that viral load in semen seems always to be higher than in blood, which is one of the reasons integrase inhibitors are rising in importance: they go where other ARVs daren't. The unspoken fact is that someone with VL (via blood) under 1K (the current PrEP studies take 200 as undetectable, while the UK hospitals generally reckon on 50 as undetectable - moving goalposts!) is on the borders of being infectious...

I'm a volunteer with myHIV, a subgroup of the British charity Terrence Higgins Trust, which is the main HIV charity in the UK. Because I live some distance from any of our testing centres, I'm not the one who gives the news. However, since we're an online community, and I'm judged too sick to work, I often pick up the the first email contact on our forums. If not the first email contact I end up filling in the blanks left by other volunteers as I'm one of the long term survivors. It's difficult (especially knowing that some of our users will be reading this!): there are so many myths and rumours to dispel, to get to a truth that is basically "nobody knows". My late husband (he would have loathed the term!) was late diagnosed with a CD4 count of 80 and MAI (mycobacterium avium intracellulare, a relative of tuberculosis, since you ask) making a home for itself in his guts, and died four years after diagnosis. I have to bear in mind his experience of HIV as well as that of the kid who thought "once can't hurt". I don't know if I could be the one to deliver the news, even though it's much less of a threat when I was diagnosed in 1987. I just help pick up the pieces and help the guy (or woman) put them back together again in some way that resembles their normality. It's a peer to peer situation: I can give details of how I handled a situation, without recommending my ways to the person I'm talking to (on the occasions I leave my house to go further than the village shop I'm liable to be wearing a cutoff that carries a lot of gay and HIV badges - something I wouldn't be wearing if I were meeting a "client"). Despite being pretty much housebound I do remember what it was like to spend a night in the pubs and clubs: my primary message there is "what do you want?" <reply> "go for it". I see my job as re-instilling confidence in people who've just been diagnosed and, being unable to work at a conventional job, I have the time to maintain an email relationship with someone as long as they need. Some have crossed over the line and become friends, in which case any counselling type questions I have to refer them on to someone else. But yes, that first contact breaks my fucking heart.

When PrEP was first available, I was extremely doubtful about it, having just nearly died from kidney damage caused by one of truvada's ingredients - I was still in hospital when PrEP became available. But it appears that neg guys and poz guys appear to process the two drugs differently, with the neg guys handling the two drugs better than us. PrEP offers us a proof of concept and if we can get so close to right at the first attempt who's to say that what comes next won't be better and cheaper? I think the poz guy's role in PrEP is to support the decision to take it and also, if he's taken truvada himself and notices side effects happening (and they can be insidious) to act as an alarm bell. But then I took truvada for seven years without apparent problems. If you start thinking things aren't quite right, who're you going to talk to in the wait for you doctor's appointment? Me, I'd be asking someone else who's taken the same drug... Frankly I'd rather fuck with someone on PrEP than someone who tested "negative a few months ago" because the few months ago can turn out to be a lot longer time ago and the protocols for dispensing PrEP demand an STI workup. Guys on PrEP have to take better care of their sexual health if they want to stay on PrEP. I'd warn against skipping doses, though: it's possible to skip the wrong one and end up with an unwanted passenger. I take something like 25 to 30 pills a day and medication fatigue is an easy trap to fall into. Easier, I'd imagine, for someone taking something prophylactically than for someone taking meds as treatment.

About ten years working with Lesbian and Gay Switchboard from the first reports of "strange cancers and pneumonias" 2 years working with National Aids Helpline 2 years working with Body Positive 3 years working with myHIV* *myHIV is an internet project, the rest are/were telephone projects

I was asked this question as part of a research project in the early days of HIV. My reply was "I don't know: I was supposed to count?" We settles at 300 to 400...

This was long before the days of TasP: We hadn't even got as far as protease inhibitors. But the event decided me that no-one would ever have the chance to deny that they were fucking with someone with HIV. I've long said that the only two HIV statuses are positive and unknown. It's the guys who thing they're negative that are most likely to have HIV unknowingly. Not being a fan of STIs, I tend to avoid them lest they live up to their reputation of multiple infections. Get tested, guys, have regular STI workups. If it's available give long and hard thought to PrEP.

Last year I took the biggest cock I've ever taken, bigger than any of my dildos (well, if you're on a limited income due to HIV you don't have so much money shop for for the ones that do the job). I couldn't get his soft cock entirely into my mouth and he was a grower. My advice to anyone faced with a similar challenge is let him take charge: he knows through experience what works, even if he did comment on my asshole being unusually tight. He got my trust, which allowed me to relax and let him in through the second sphincter. Scrape me off the ceiling time...

Going back to the first it's the time I spent going through all the pre-fuck stuff with an American guy in the Block in London. After the first pause for breath (no sex in the bars then) a bit of conversation. As soon as he realised I was HIV+ he walked off without a word. From that date to this (20 years - fuck me!) I've never got into a sexual situation without the other guy(s) knowing. In clubs I've used the metal red ribbons, and as time progressed the precious metal ribbon that National Long Term Survivors Group give out when you hit ten or fifteen years (the drugs were too good: we stopped doing them after fifteen years). For parties or whatever, I've got my biohazard tattoo. No-one is ever going to treat me like that schmuck did back in the nineties! All my online profiles say something about HIV. Yes that lessens my chances, but I'd rather fuck with someone who knows what he's getting into (and for certain guys, I'll even go as far as rubbers, like the guy with a dick bigger than any dildo I've managed). My simple message to guys who want but won't because of the HIV is "you don't know what you're missing."

As some of you know I'm a volunteer with a British HIV site. During my chatroom moderation I asked people how they felt about PrEP. Talk about a shitstorm! And most of the anger was coming from guys who weren't even conceived when I got HIV. Condoms are the only way - then how, dear boy, did you end up here? Opposition to PrEP that I've seen in the UK has come from 20 to 30 year olds, with us longtimers welcoming it. We've lived an artificial sex life for thirty years now, originally believing it was only going to be five years or so before there were adequate treatments. I know the UK is in trouble financially, but investing in PrEP is a money saver. And all these guys snorting every white powder up their noses (to the extent you're afraid to leave the toilet cleaner in view) get all precious about putting toxic drugs into their bodies - maybe we need a snortable version of truvada... In the case of the UK we have about 26,000 people with HIV who don't know they have it: if we can get them to test and take the pills, and the people who test neg take truvada, the whole damn war would be over... [/soapbox]

Don't trust guys whose last negative test was months ago. Maximum between STI/HIV checks should be three months, more frequently if you get around a lot. Safest guys guys are, paradoxically, guys with HIV who've maintained an undetectable viral load for six months or more. General rule of thumb is that it takes a viral load of 1,000+ to establish a "successful" infection, though this figure will be lower if he has a co-infection of (especially) gonorrhoea or syphilis (and possibly some of the other STIs, though I'm not aware of research that shows this:just because I'm not aware doesn't mean it can't happen - it just indicates a lack in my reading research!) If you both go to the clinic at the same time and both get negative results, fuck like bunnies: it's an infection, not a punishment for a lifestyle choice, no matter what the Daily Fail says. One final thought: it might be worth inventing an HIV+ boyfriend and persuading your doctor to give you truvada off-label. I've no idea if that would work as the drug is still in trial in the UK, but if you really want it, the worst they can do is say "no".

I know your enthusiasm... there are times when heaven is mutual rimming 69: each of us humping the other's chest while getting our assholes thoroughly probed...

As we used to say before the licensing laws in the UK were relaxed and bars still closed at 2am, seven out of ten at ten to two... ;-)

I have little reaction to pictures of naked women, or, for that matter film clips. They just don't interest me, and I'm quite capable of clicking onto the next image/movie if I don't like what I see. I really don't see what the fuss about straight sex here is: although it's predominantly a gay site, rawTOP has made space for straight/bisexual men and women. So what? I don't have to go look if I don't want to. This is a predominantly gay space: all I'd ask of straight/bisexual users is that they don't start with anti-gay abuse (which to my knowledge they haven't) so what's the problem?

Can't remember the name of the enzyme now, but an enzyme in mung beans (the kind you use for beansprouts) helps suppress herpes. Boil 'em to pulp with some chorizo and spice to taste...

The 5701 test looks for the presence of HLA-5701: its presence pretty much guarantees a hypersensitivity reaction, severe enough to land you in intensive care, if not a box. (I'm in the contrary position of my virus being supremely vulnerable to abacavir, yet also HLA-5701+, so it's a drugs I can't touch.) What you're describing is, to me, the "minor" side effects which perhaps 1 in 10 people get, 2 in 10 at a stretch. Don't forget that there's a lot of stress involved in starting a new drug: your body has to respond to this strange new chemical you're throwing at it, which is why rash and temperature are the most common side-effects of most drugs. The headache is probably stress. If you were going into hypersensitivity, it would have probably happened earlier, and you probably wouldn't have been able to write the above message. I'd suggest you ride out the month and see how you feel at the end of it: then, if you have any potential side effect issues, discuss them with your doctor. At the risk of repeating myself: you haven't described abacavir hypersensitivity!

"STD free" is also making assumptions we could do without: what about syphilis where the primary chancre was in the lining of the ass? Happened to a friend and the first thing he knew about it was when he was told he had secondary syphilis. 50% of men show no symptoms with chlamydia. Genital thrush can look like excess smegma. Warts can look like skin tags.

CD4 counts can vary from moment to moment. I always try to have my CD4 done under the same conditions (time of day, snack beforehand, and so on). The only real variable is the nature of discussion with my doctor. 489 is considered, in the UK, too early to start treatment unless there's a pressing reason like a serodiscordant partner (our limit is 350, but I push for the higher limit). But the way CD4 counts change, 489 might as well be 589 - a hundred or so at this level makes no difference. And 42% is just bloody amazing! The once I got above 30% I was well pleased with myself. Here's to another successful years!

And the object is to be a well patient, not a good patient...

Pozdaddy 28 Over the next week or so we film the extras. They’re all the sort of thing that you watch once and don’t bother with again, much like a magazine article. Even so, they have to be spot on with our philosophy: we work as an extended family of choice. No other great insights although we decide to add in a safer sex message: some of us chose the virus, others of us had no idea it was even there, and for some of us it was an accident. The single thing that comes across from all of us is that there’s no shame in being poz, no matter how you got it. It’s difficult doing a serious interview when you’re getting a blowjob... Next job is printing the sleeves and copying the disks. I set Pozboy to the printing, copying and packing while Mochyn gets to work on the advertising, even remembering to add a link to the online extra. I keep them working long hours in order to be ahead of the orders that start trickling in the moment the adverts are online. Otherwise the household runs as normal: it appears I’m the only one who remembers our hospital appointment at the end of the week. I decide to keep that worry to myself and let them make up the DVDs and begin to send them out. By the time we get to bed we’re too damn knackered for sex, though I still get my morning blowjob. But not on Friday: knowing the hospital routine better than them they can piss only if they’re bursting and there’s no breakfast. We get to the hospital in good time and when the both of them start complaining about really needing to piss I organise sample tubes for them as well as having one for myself. My mind wanders off to piss denial as a possibility for fun. What if one them has a bladder so full that even the attempt at getting a dildo up his ass had him pissing himself? I make a mental note to learn more about catheterisation. We’re called in to see Dr Sandra bang on time. “I presume you’re all willing to discuss things together? I know you are, but I have to check each time for the record.” We each nod. “Right then. Poz, you’re holding your own pretty well, but I want you on meds full time.” “About what I expected.” “Mabon and Mochyn: today’s bloods will show what progress you’ve made. The number one question right now is any side effects?” Both boys shake their heads. “Let’s keep it that way: the sooner you start meds the less chance of side effects, so I want to keep you on the same drug, since you’re not getting any problems with it.” She grins somewhat “physical exam time boys.” We check out ok, and the printer whirrs: “next month’s prescription. Might as well keep you in line with the lads, Poz. Make an appointment for a months’ time. See you then...” We head off to the pharmacy and I ask the boys “now was that so bad? Dr Sandra is always okay unless you’ve been really stupid...” Drugs collected, we head for home. “Day off today, lads” I say “just normal household stuff – you might want a nap later: we’re off out tonight: might as well get some use from the sauna gold cards. One restriction: no fucking or getting or getting fucked without a condom. You’re not wasting your drugs by getting another strain. We’ll review that situation in a month when we know where you viral loads are heading. Bill and Ken are okay, as are their boys, but until I say so your primary receptive sex organs are your mouths – and we know how much shit you can talk.” I can’t resist adding in that last bit. Mochyn will take it to heart and Pozboy will see it as a challenge. Once home, I relax with a book while the boys get on with the housework. I muse a little on the wonder of daily help that I can fuck, before I doze off. I wake to the smell of pork cooked in cider being wafted under my nose. The pork steak is well trimmed of its excess fat, loads of paprikas, fresh ones too from the look of them, onions and brown rice. Someone’s been in my recipe file... That sort of snooping I can forgive. “Mochyn – get a bottle of white – it’s been a good day and we’re celebrating, so it’s a taxi job tonight.” Mochyn returns with the wine and pours for all of us. I take a look at his plate: the rice is shoved to one side. “Don’t like brown rice? Learn! It’s a damn sight better for you than white rice.” He eats the rice, a little more enthusiastically after I mention that unrefined foods make douching a lot easier. We have another review of the DVD, concentrating on Pozboy’s and Mochyn’s scenes: I want to be sure that they’re happy with them being available to Joe Public. Rather than worry I get comments like “I really enjoyed that bit” and “you could have gone harder there”. Kinda disturbing that they really got off on the “rape” scene... Not that I’m worried about what they might do, more that I’m worried about the attitudes that scene might instil in them. The air stinks of sex: I send the both of them to get dressed for the sauna. Not so difficult a job as we only need to be seen dressed in the reception area. My only comment to their harnesses is “I hope they’re properly oiled”. For the rest, both in leather jackets, one in chaps, the other in leather jeans, and both in bike boots and dress collars. I’m pleased to see that the wages I’ve been paying them have gone to good use, even if I do pick up the bulk of the bills. In denims, vest, jacket and boots, I feel somewhat underdressed alongside them. But what better chance to show them off as mine? The taxi arrives and we’re soon at the sauna. As we check in, the guy on the counter raising his eyebrows slightly at our membership cards, I glance over to the bar area and see that we’ve attracted attention there. After making sure that our bar bill is on a tab, we go to get rid of the clothes. I opt for total nudity (except for a cockring), while the boys keep their boots and harnesses, Back in the bar area, Mochyn is all set to get us wine until I point out that wine isn’t much use if piss-sex is on the cards, so the boys have a pint of lager (I must do more to educate their palate as regards beer) and I have a Newcastle Brown. We make inconsequential conversation, with enough sex references to interest anyone listening in. We’re all aware that this sauna visit is, if you like, an informal public appearance to promote Pozitive, which started onscreen in the video room the moment we entered the building. Their opportunism, not ours... though I couldn’t be more pleased. Beers finished, I decide it’s time to see who’s around. I warn the boys about no anal without condoms (I want true readings next month and I’m afraid their potentially taking on board extra virus might screw that up) and let them loose. My first port of call is the video room – I want to see how Pozitive is going down. It seems that “going down” is the right expression: if it weren’t for the bodily reactions of the half of the audience I can see and the occasional swap in positions, I’d judge it a failure. I make a mental note to increase production of original discs. I’m leaning against the wall just inside the doors, relying on people’s instinct to glance at who just entered the room. Onscreen, Pozboy is getting his ass belted by Jim, offscreen I catch the whisper going round “it’s him isn’t it? The one whoring out his boy in the film?” I do the best I can to make no acknowledgement of the increase in attention paid to me in the room. Eventually I’m approached by a youngish couple who kneel in front of me, their eyes begging permission, and soon I’m getting a double blow job, A good start to the night. A third comes along and makes it clear that he wants at my balls. I push one of the original two aside to make room for him. More guys come along so I move away from the wall to give them a bit more access, all the time paying attention to the screen than to them. Six or seven tongues working across me, biting, teasing, trying to be the one who gets my cock in his ass while I fuck Pozboy onscreen. I’m particularly taken with the bearded rimmer. It’ll have to be another time though. Strange as it may seem in a sauna, I’m saving it up for the boys: I’ve never been a multiple cummer, and their good behaviour (so far) today has earned it for them. I slowly detach myself from the group and head off to the sling room, where I’m fairly sure I’ll find both boys. Surprisingly, Mabon is fucking Mochyn, which I suppose is a way around the condom rule I instigated. Not many guys in the sling room so I point out the fact quietly, adding that half the point of tonight is to be seen and identified. “Pozboy: your turn for the bar. I’ll have another Newcastle Brown.” I settle in one of their big leather settees, and wait for the boys with my drink. “Get seen much?” I ask. “You will after tonight: as far as I could see most guys were watching the movie.” I smirk. “If they don’t recognise, they’ll recognise me” I’m leaning back on the settee, with each of the holding on to a leg, clutching a bottle of real beer with his other. They start a game where the object seems to be to fill their mouths with cold beer and reduce my hardon. They don’t succeed. As this is going on a mildly muscled guy with red hair approaches us. Although ginger myself, I have something of a fetish for ginger. He’s carrying a tray of four bottles, three of which match our chosen drinks, so I can only think the fourth is his and he hopes to stay. I recognise the beard: he was trying to tongue-fuck me in the video room. “See boys? This is how to treat your Boss – watch and learn!” I spread my legs a little further and suddenly have one on my dick, one on my balls and, with a little wriggle forward, one in my ass. I could have stayed in that position all night, but had no intention of coming in the sauna. I pull free and say “If you don’t feel sociable to talk to our new friend you could at least entertain him”; good boys: one sucks him off while the other rims him. I make thing awkward by talking to him. “So your name is...” “Bryn, Sir” “And you like...” “Precisely what’s going on now, Sir. But I’d be loving to suck you off now, Sir. To have you take back into the playrooms, have you restrain me, hurt me, fuck the ass off me. Own me.” “Maybe in time. Some things you need to know: me and my boys are a family. Sometimes I take note of what they say about a guy, other time I tell them to go fuck themselves. I like a peaceful life: if they really don’t like you I’m not messing up my home life by taking you home. The other thing is that we’re all HIV+. We’re all three of us waiting for viral load tests, so we’re keeping it safe for now. If that’s a problem, I want you outta my sight in about ten seconds. I don’t like guys who don’t trust.” “No problem, Sir: do your boys get a choice?” “They made theirs... And before you ask, I pozzed them both because they wanted it. Just as I’ve made the decision that we’re all on meds now.” “Until we get our tests back we’re keeping everything safe with strangers.” “Sir, I started on the PrEP study a couple of months ago.” “Good for you, but until I know me and my boys are undetectable it ain’t relevant. Now are you going to relax and drink that beer? Oh, and I presume you’re coming home with us?” “Yes please, Sir!”

Smoking: poptronic, I stopped cold turkey. It's a question of choosing your time right. PM me if you want more details. otebbtop: as someone with a now unrealisable smoking fetish - I used to like moderately dark 7" or so cigars and I couldn't help but inhale - it is possible. I've lost about 30% of lung capacity to smoking, which is why I say I can't afford to go back. The smoking porn has always been there: I used to help run CigarmenUK back in the nineties, it's just with the increase in society's disapproval of smoking in any for, it's become more obvious and more transgressive. I remember Bear magazine doing a cigar special in the mid nineties (at a time when Bear was considered by UK customs). Fortunately our copy got through and was practically ripped to pieces at our regular CigarmenUK meetup on a Sunday afternoon. The "new wave" of cigar porn gets to me: I keep thinking of ways I could put it into action without inhaling... My only experience of giving up tobacco has been as a user (ie I'm not a counsellor) but if anyone wants to give up smoking, I'm happy to support you.

Absofuckinglutely! It's why I'm in the hit it hard and fast group. I seroconverted before there were drugs available and there are days, although I'm basically physically well, I just don't want to get out of bed because it's started hurting already.

An excellent piece! The only way I could fault it is that it's not clear enough in its opening that guys are getting truvada on prescription. I note Gus Cairns in the comments: he's one of the most respected, sensible and practical commentators on HIV in the UK. As regards reclaiming language, it's a no-brainer to me: the abuser always comes off worse if I get called out in the street.

If you're nervous, err on the side of caution: it's your body! If swallowing a few extra truvada pills makes you feel better psychologically, go for it. Psychological health is just as important as physical health. I'd reckon that 7 days after your last risky encounter is more than adequate. Making the PEP comparison again, PEP is useless after three days because by the HIV has got a grip: if your last sex involved you taking a positive load, there was already enough truvada in your system to deal with it. The extra doses you're thinking about are for reassurance. And yeah, were I in your position, I'd probably go a few extra days too "just to make sure": if I need an antibiotic that's normally prescribed for a week, I always ask for a ten day prescription and so on.

Undetectable refers to the amount of virus circulating in the blood. There is always some virus hiding in lymph glands and the gut, and semen appears with most drugs to have a higher viral load than blood. Integrase inhibitors are liable to prove very important as they have deeper tissue penetration than other drugs. Twice last year my viral load came back as zero, which I attribute to raltegravir/Isentriss: both times I checked with doctor, nurse and pharmacist, I was so stunned. It's not a cure: the virus is still hiding in various tissues, but it does imply that the viral load of semen will be lower.

I can only attempt to explain for the UK: the body that controls drugs takes little notice of what other nations have found so we regularly get medications approves a year or two after they've been approved in the USA. As an example dolutegravir has been available in the USA for some months now, yet it's not expected to be available in the UK until next year. I've little experience, really only hearsay, of how the private sector handles drugs (except that they're always at full price - a rich bitch has got to make her money somehow). Citizenship of the UK automatically means you're entitled to National Health Service treatment in any of the four countries. In Scotland and Wales, prescription drugs are free, I don't know about Northern Ireland, and in England there's a charge of about £8 or so per item which can be heavy on the pocket if, like me, you have a double figure on the items on your prescription list. For that reason there's an option to buy a "season ticket" costing about £100 to cover a year's fees. When I last lived in England, my local clinic was giving the season tickets out free. Depending on the hospital you use, you can get medications for "off label" use which implies that you could with a lot of screaming and shouting get truvada prescribed. My late partner was prescribed interferon off label as an immune booster. I even learned how to do sub-cutaneous injections to save a nurse from having to visit. Getting medication off label isn't easy but it is possible. With truvada, it would be useful to have a positive partner, with a viral load above 1,000, who is repulsed by condoms to bring along to appointments. There are eight test centres in the UK (I think all in England) where it might be easier to get fitted into the PROUD study as a latecomer. But I'm afraid that the more common response is going to be to make sure your partner's viral load is undetectable (TasP - treatment as protection). But then the thought comes a lack of faith in TasP could justify off label prescription of truvada. Shit, but the health service is in a mess all over the UK!