bearbandit

The most frustrating situation of all. Side effects, if they happen, are a month of feeling like crap. Once your body's used to the drugs, it relaxes. The common side effects of truvada are list in the 1 in 10 people range (which I read as 19% - the information sheet is further advertising, and allows them to round the numbers downwards). Listen carefully: SIDE EFFECTS ARE NOT COMPULSORY! Sorry for shouting, but some people need it. I'll be honest and say that I have a lot of problems with side effects, but that's because I limped from new drug to new drug starting in 1989, when the main objective was to save some lives with the drugs that were available: I started with AZT monotherapy and survived it. A number of my friends didn't. But things aren't like that any more: there are enough drugs now that you can change combination several times before finding the one that fits your lifestyle and doesn't make you sick. I always recommend people give a month or more to work out if that combination is right for them - after all we're talking pretty serious chemicals. You always have a right to switch to another combination. No-one who's had sex can know that he's negative. All a negative test result means is that what they were looking for wasn't visible. I work on the principle of HIV+ and HIV unknown. If indeed it turns out the the "unknown" guy actually is negative I can't turn round and say "tough shit, kid" nor am I willing to be Pozdaddy. If I were HIV- and in the USA I'd be at the head of the queue for PrEP...

If it's any consolation, even after all these years (diagnosed 26-1-87) I get tensed up at results time. It's human nature. Stribild for seven weeks will have put the virus into its place: the highest number I'd expect would be three, maybe four digits. The lowest of course, undetectable. I can't take Stribild because it contains tenofovir, to which I'm seriously allergic. I'm waiting for dolutegravir (also in Stribild) to be made available as a single drug here, but I'm not holding my breath. The integrase inhibitors, like dolutegravir and raltegravir, I believe are going to cause just as much a revolution in HIV treatment as protease inhibitors did in the last nineties. Expect a low VL, but don't be surprised if your CD4 count takes a while longer to build up to what's normal for you. The CD4 count always takes longer to recover and you very probably don't know what the starting figure (the "normal for you" figure) was. By the "normal for Steve" figures I'm anaemic at present as I've always been at the top end of the generic normal for men figure and now I'm a couple of points below it. I'd urge you to keep a record of your blood results: that way you'll get an idea after a few more vampire visits how things are going. If you graph the figures the CD4 should be going uphill and the VL downhill. As a friend of mine says "it's the trend that counts". I'm a believer in hitting the little bastard hard and fast - the hell with having to reach a certain CD4 count. Wishing you the best of luck when the results come in...

In the UK it generally takes a couple of weeks to get the result of a viral load test, longer if there have been bank holidays in the way. Unless there's been a query about a blood test I tend to just leave it till the next time I'm at the clinic; I've just changed clinics so I'm on a much shorter interval than I was as the new clinic works out how the trends are going. When I phoned my old clinic to ask them to send me emails of my bloods (14 days after the vampire) viral load was the one that wasn't available yet. It's a pain in the ass, but VL is always the last result to come in. While you may have blipped out of undetectable, I'd doubt it would be by any great figure. In a seven month drug holiday some years ago (and remember I've been diagnosed over 25 years) while my CD4 count plummeted (880 to about 200), my viral load only went from undetectable to 65,000, enough to make me mildly infectious. It's possible that after your three weeks of PEP they're re-testing the same sample to be sure of the reading: you're in an unusual position. I can understand your wanting to know right this minute, but if there's one thing you learn in the HIV game, it's patience. 3 weeks from Vampire to VL result wouldn't surprise me! I think it's probably reasonable to start daily phone calls on Monday. Right now, you're making stress for yourself.

ARVs are designed to have a long half life. I believe it takes the best part of a week for the body to get rid of the last dose of truvada. The tenofovir component is especially aggressive towards HIV. Remember that with PrEP if you have taken on board some HIV, your body is already an HIV no-go zone. For PEP, the HIV sets up home first and starts multiplying (which is why PEP is pointless after 72 hours: HIV, if present, has got into enough cells to establish itself) so the drugs need to be heavier and taken for a longer period of time because you're treating a potential infection. I repeat rawfuckr's question: what side effects are you having? Many are avoidable, and for the unavoidable ones there are ways around them. I took truvada for about five years, as treatment rather than prophylaxis, and still take the FTC component, the tenofovir component having caused kidney damage. I fell out of the side effect tree years ago and I swear I hit every branch on the way down - I might be able to help with ideas to avoid trouble.

I think it's simply acknowledging the animal side of our nature. I had a rottweiler who used to help people with a fear of dogs. He was obviously the runt of the litter, though he had quite a distinguished pedigree. One day I was walking him and a mastiff tried to pull the dominance thing of mounting him. He wasn't having any of it and the fight ended with his teeth pressed against the mastiff "I could have you if I wanted to". I think we, as gay men, many of us with at least a passing interest in BDSM, show similar characteristics, especially during sex. Which is not to say that it's essential: I'd be hard put to decide which I wanted more - a night of hard sex or a night of quiet intimacy. As I said above I recovered from being raped (and I truly did think I was being murdered) by re-enacting it to the point where it's a turn on for me, because I know I'm the one with the stop word. As an aside I volunteer as a peer supporter for people with HIV, so I guess I kinda fit into the role inversion thing. On the increasingly rare times I top I've been told I'm fucking dangerous (in a good way). But that doesn't preclude the fact that I enjoy going to sleep holding or being held by a nice hot man...

I find it amazing that you can do such a thorough demolition job on versatile guys and finish with such a euphemism as "they'll sleep with anyone". I'll have you know I'm pretty picky about who I fuck with (did that offend you sensibilities?). And in what way are tops less risky for STIs? I'm sorry, I've only been around the gay scene for forty years: never yet met a total top...

I see the world as being divided into nurses and patients. I've always been a nurse, which is why I've worked as a volunteer on so many helplines. It does, however, mean hours of listening and not getting laid at the end of it all... <sympathy>

Good question... I was raped at the age of 19, though my anger resulting from that as directed more at the then current British law which would have had prosecuted me as well as the rapists. I've long ago resolved the issues surrounding the rape, but am aware (and when I get the chance) act upon fantasies of rape. My late partner, who was a much guy than me, especially as I was going through HIV wasting at the time, sat me down down for the "something's not right" talk. What wasn't right was that I'd be in the sling screaming "no" when I actually meant "yes" and he didn't know which I meant. An agreement to re-instate the stop word system put that to rights... I'm always cautious of sex addiction literature: while it's true that a few people have a problem with inappropriate behaviour, in general so called "sex addicts" are simply people who're getting more than you are. The cycle of escalation you quote is, to me, complete nonsense. What of the guy who discovers he likes torture or being beaten before he discovers he likes piss? What is kinky? What is mundane? For that matter, what is violent? It wouldn't be the first time I've attended a gay community meeting proudly bearing the bruises I got the night before. What I have noticed is the increase in rape involving drugging someone first. To me, that fucking stinks (as does any form of non-fantasy rape). I know several guys in the UK who've acquired HIV as a result of such rapes. Double trauma. At least I got HIV while I was having fun rather than being in fear of my life. The important word is "consent". I've had guys complain about my Pozdaddy series because of the sexual violence that occasionally shows up, but I'm always careful to make it clear that the violence is consensual. Admittedly you sometimes have to go back a few episodes to find the consent, either direct or implied, but it's always there. In short violence and sex can be great fun when consensual, and it can be your worst nightmare when it isn't consensual.

Pozdaddy 27 Ken pauses the DVD. “Fuck, if I knew that was even possible...” “Why haven’t you done that with me, Dad?” They’re both all but humping my boots: I think the scene got a good review, even though I’m somewhat surprised at their naivety.. “Think of the size of the toys you’ve been taking lads. Weren’t you suspicious when the smaller ones started disappearing?” “Sneaky bastard...” mutters Pozboy. I decide to let it go for the moment and send him off for the other bottle of wine. When he returns, there’s a butt plug where he was sitting. “Sorry, Dad. I know: I let my mouth run away with me.” “Take the wine round, then sit down and shut up.” After pouring the wine I can tell from his breathing that he’s pushed down on the plug in one movement. Contrition or just showing off? Could be either with him. We pay less attention to the scenes we’ve already reviewed, though I notice Pozboy sniggering quietly at the “rape” scene and give him a clip across the ear. We’ve reviewed these scenes often enough that we’re only watching to see if they hang together in context (if there’s such a thing as context in a fuck movie). A ring at the doorbell: turns out to be Bill with the pup in tow. “Heard you were doing the final review tonight. Thought I’d drop in and how it’s going.” “Mochyn – your turn. Get a glass for Bill and another bottle of wine.” Aside to Bill “Is the pup allowed glasses yet or is he still on bowls?” “A bowl if you have one,” I raise an eyebrow “which of course you have” he laughs. “Mochyn – a small drinking bowl for the pup.” Mochyn has the good sense to bring an extra bottle, given that we’re now six. As I remember there’s just the scene with Bill and the pup left go. As a tattooist, he’s a damn good artist: he’s done most of mine after I met Ken. There’s a different quality to the light in this segment, which is only to be expected since it’s in Bill’s studio. The pup is naked, strapped down to the bed, but with a hand free for poppers. Bill, wearing just a jock, traces out a biohazard at the base of his spine just below where the band of the pup’s jockstrap would be. Showing the whole tattooing process would be ridiculous, so Ken has handled it with a series of dissolves so that the tattooing is always in real-time. The pup helps himself to poppers as and when. The only difference from doing a job in the studio is that Bill’s almost naked and he’s not wearing gloves. And of course the poppers. Seeping blood is wiped away as normal with a tissue, but when the occasional drop forms Bill scoops it up with his left little finger and smears it across the pup’s back. Eventually it becomes apparent that he’s spelling out the word “pup” in blood. When the tattoo is finished and the protective clingfilm applied Bill unstraps the pup, pulls his hard dick out from his jock and pushes it deep into the pup’s ass, only to withdraw after three or four strokes. “Turn around and face me. Now thank me for your new tattoo.” The pup, slightly mindful of the residual pain of the tattoo, dives onto Bill’s cock until his nose is buried in Bill’s pubic hair. As he sucks on Bill’s dick he occasionally chokes. The first time that happens Bill leans over for the poppers and holds them to the pup’s nose. The pup goes into a frenzy of sucking. “Yes, you can.” The pup beings jerking himself off, but makes sure to pay more attention to Bill’s cock than his own. Eventually Bill is face-fucking the pup while the pup struggles not to choke again. Suddenly Bill pulls back and stops the pup from reaching forward with one hand on his head. “Please Sir, please... your cum... Please Sir, can I have your cum?” Somehow they manage to cum simultaneously, the pup into his own hand and Bill all over the pup’s face. Bill looks down at the pup and simply says “Eat it” and walks away. The scene closes with the pup eating first his own cum, and then collecting as much of Bill’s as he can and eating that. Fade to black, followed by a fade in clearly shot some weeks later. The pup is on his back, legs in the air and the tattoo is healed. Bill is gripping one of his ankles and is teasing the pup’s hole with a dildo. There’s obviously been some play going on beforehand as the pup is nicely sloppy. Bill throws the dildo to one side and pushes his cock into the pup’s hole. The pup looks up at Bill as though it’s the first time he’s ever been fucked: an expression of wonderment and gratitude. “Please Sir, I’m very close, I can’t take much more. I’m sorry Sir.” Bill’s only answer is to start fucking him. A close-up of the pup’s hole with Bill’s cock deep in it, then the camera pulls out and moves around slightly so both their dicks are visible. They both tense visibly and the pup almost screams as he begins to cum while Bill merely grunts as he forces his cum into the pup. He rests a moment before walking round to the pup’s face, at which point the pup cleans Bill’s dick. Another fade to black and this time the credits. “Okay – how do you guys keep managing simultaneous orgasms?” “Practice – lots of practice,” smirked Bill. “So what did you think?” “It’s good. I like the way you bring out the eroticism of tattooing – Bill’s never let me use poppers when he’s been working on me, but there’s a definite connection there for me. And the second part works – makes the viewer think ‘what were they doing before’. Sometimes what you don’t see is hornier than what you do see. I think we’ve got a DVD once we sort out some extras.”

I'll never forget the thirty-ish guy who was chatting me up on Grindr. "what's you HIV status?" I asked. "What's HIV?" he replied...

Two examples (seven year openish relationship with the same guy, rules of his devising): rule #1 we go out together, we go home together. He jumped off the bus on the way home to follow this guy and couldn't figure out why the door was locked when he came home. A promise broken. rule #2 you don't fuck with the same guy twice. After we broke up I discovered he'd gone through a string of short term relationships. Neither of these would have mattered if the rules weren't there. My problem was that he was essentially lying to me. When I was very ill with HIV my (later) partner had a string of boyfriends, all of whom were welcome in our home. They gave him what I couldn't. Even before I was too ill to fuck our rule was simply to be honest about who else we were fucking with: hell, the man even drove me to my boyfriend's place, returning an hour later because I'd forgotten to bring my ARVs with...

The obsession is with the number: I've been recalled to the clinic when I've blipped over the 50 mark (87) having had two zero results immediately before. I guess the point is that the earlier a rising viral load can be spotted, the sooner evasive action can be taken, whether it's a review of food-with-drugs, adherence or simply a warning that resistance (which can't be detected below VL 1,000) may be developing.

The advice we used to give at Gay Switchboard in the seventies is still relevant: if you're not in a totally monogamous relationship, get an STI workup every three months whether you have symptoms or not.

Remember also that "undetectable" is a moving target. A few year ago 400 or 500 was considered undetectable. The number decreases as the VL test used becomes more sensitive. My last hospital just raised the undetectable number from 50 to 70, because that was the limit of the result that their new lab could provide. There are a few hospitals in the UK that consider undetectable to be under 20. Also worth bearing in mind is the fact that it takes a VL 1,000+ to be definitely infectious (however weakly).

Viraday contains the two elements of truvada, plus a dose of efavirenz, which is over-egging the pudding for PrEP. Efavirenz has possibly the worst side effect record of any currently used ARV. Up to 20% of people taking it endure sleep disturbance, depression, over-vivid dreams, hangovers the next day, lack of concentration. Its effects are so marked that some HIV specialists will only prescribe efavirenz to people who don't need to be able to concentrate the next day. A friend of mine, a pharmacist, has been told when it comes to treatment time he will not be prescribed efavirenz or any drug containing it. Since Viraday/atripla contains both FTC and tenofovir (the components of truvada) I see no reason why it shouldn't work. It's the efavirenz that's the problem. Another problem is finding a doctor familiar with what atripla can do and the changes in your blood. There's a reason for atripla being prescription only and only available from HIV/GU clinics: the changes indicative of liver or kidney damage can be subtle, but can accelerate quickly. Finally there's very little data on efavirenz when someone doesn't have HIV. The safest solution I can think of is to invent a partner who has HIV and with whom you always bareback (perhaps he insists on it?) - there's a chance you could get truvada on compassionate grounds if you can find the right doctor. After all that, it'll come as no surprise that I don't think taking viraday as PrEP is a good idea. Sorry.

That's why mine's on the back of my neck. In winter, only partially visible (but visible enough for guys to work out what it is). In summer, totally visible.

Have you tested for diabetes? One of its nastier little tricks is to damage the nerve which controls blood flow to the dick; viagra was originally developed to solve this, amongst other physical problems. In the UK many pharmacies will do the test, though it's so simple if you know with someone diabetes you can do it yourself. Fast for ten hours (no food, no water, spit out any water you use to wet your mouth), a sharp prick in the finger to get a drop of blood and place the test strip in the blood to soak it up to the meter. Reading a few seconds later. A reading of over ten (old) units suggests you should see your doctor for advice.

Poz 1956, My deepest apologies: I've got to the point where I have reading glasses, computer glasses and TV glasses, and I simply didn't expand the image: I saw it at mid-morning when all the little monsters are taking up the local bandwidth. Sorry I got your message completely wrong - thanks for making it plain that I'd made a complete fool of myself before anyone else!

The advice to avoid the first piss of the day is good: full of toxins. I had a piss slave, oh, twenty years ago, and he wasn't allowed the first piss of the day. Cloudy piss is a warning sign: there's likely to be a foreign (to you, not necessarily to him) bacterium in it, so it's best avoided. For me, drinking came naturally, but some guys have piss that could strip paint (usually the result of too much salt in their diet). All you can do then is swallow fast, and maybe make him a low salt meal on a future date....

Have to admit that I loathe the duck in the bath one for its sloganeering: clean? A reqgular question I ask the guys I fuck with is "Sweat: prefer several days stale, just not showered today or straight from the shower?" (I like to cater to all tastes.) Given the window period period between infection and evidence (ie antibodies) is strikes me as shooting a hole in your foot. How many times does it have to be said that you cannot prove a negative? All you can say is that HIV antibodies, hep C antibodies, evidence of gonorrhoea was not found in the sample. When I lived in North Wales I had a long conversation (heard by everyone on the bus - only a 15 seater) with our local Goth who genuinely wanted to know how to keep safe. Myfanwy and Emyr learned a lot that day...

As I recall the original was "don't sweat the petty things, lick 'em instead, and if they roll over for you take 'em home."

Jizz, I take those words as my own, but as words of reassurance: Given the choice of the miraculous disappearance of either HIV or diabetes, yes I'd sooner be free of diabetes. Thanks to a new consultant, I have renewed belief in my ability to live with HIV. Perhaps go some way towards reversing my early osteoporosis, get some of my body strength back.... For those who don't know me: I seroconverted in 1980: no-one knows where I'm going now (except me: I'm about the hit the sofa!) Steve

"The beginning is a very delicate time." Borrowed by another HIV worker...

Difficult question that - being proud to be poz... Makes it sound kinda attractive. I've come to the conclusion that I'm proud of me for dealing with being poz (look in the old posts, you'll find many where I'm equivocal). I got my biohazard tattoo before the diabetes got to the nerve that keeps the dick hard - my idea was that it identified me as poz to anyone at a play party and if they'd rather not, well I didn't fancy him anyway. Now it's basically an "up yours" to the haters (it's on the back of my neck and no matter what I wear, part of it is visible). My pride in being poz is the antithesis of being ashamed of it. I'd give more thought to PrEP: negative guys seem to respond differently to truvada. Yes, there are risks, but there are risks crossing the road. I used to use the biking comparison for risk, but one day I totalled my Suzuki Bandit, getting out of it with only a broken ankle. Shit happens. So do neuropathy and osteoporosis... If this is the joy and freedom of being poz and fucking whoever/whenever, why am I usually in bed by ten with a book, why do I walk with a stick, and why do I have to have friends do jobs for me that I could quite well have managed a few years ago before my health went down the pan after twenty years of careful medication? He asks in bad example mode... If you're sure of your fuck buddies, fine. For me If I was just coming out now I'd want PrEP because of this dreadful secret: some men lie to get what they want...

If PrEP is available to you, go for it. It will allow you to continue your present sex life without the risk. Believe me, you do not want HIV. As well as the pain of other opportunistic infections there are also the long term effects. Essentially my skeleton is twenty years older than I am: osteoporisis. I have constant pain from neuropathy, some of it caused by early drugs, yes, but the rest of it caused by HIV. Early drugs caused my diabetes, though even with the current drugs, diabetes is still a possibility. One pill a day, as opposed to my thirty. You sound an ideal candidate for PrEP (lucky bastard!) - protect yourself, and whoever you're fucking with.