bearbandit

Since no-one else has mentioned it, there are a couple of contra-indications for poppers: if you're on any medication for blood pressure issues, be careful with them (they were originally used for angina), and be careful too if you're using viagra or similar as those drugs work by messing with blood pressure. What I do is to take just a small sniff to start with and gradually increase how much I'm using and if anything doesn't feel "quite right" I take that as a sign that I've gone too far.

There are no "shoulds" to fucking beyond that of consent. If there's power-play going on, might not a top demand that his boy is rock hard, but not allowed to touch, throughout? Just one example of how it could work... The important thing is that everyone gets off (or maybe doesn't in some power-play situations - but even then there's an emotional orgasm of having done it right for Sir). And this search for the total top who's going to poz someone up... how the hell do you think he got HIV? Not such a total top is he? The simple fact is that a dick up your ass feels good, some guys react by getting a hardon, other's don't, you just adapt to each other's preferences and reactions. And it's perfectly possible for a top to make his boy fuck him. Leave the rules to the Boss, who'll have his own idea of what he wants, but make sure that what you want fits into his parameters. Outside of that, rules are for people without imagination. Just have fun, for fuck's sake!

Assuming the other bottom as a high viral load, then the chance of getting HIV would be about 1.4% were he to cum inside you. Cross-infection? Unless he bled while getting fucked and a significant quantity of that blood got trapped under the top's foreskin, the odds are so small that we might as well say impossible. The key to staying HIV- is using PrEP: others here will be able to point you in the right direction in the USA, and in a number of European countries and Australia there are campaigns to get PrEP authorised. Outside of the USA the British site http://www.iwantprepnow.co.uk/offers a guide to buying generic truvada and the tests you need to have performed regularly - it shouldn't be too difficult to translate the British health system to your local health system... However, ATM and a top going from one ass to another without washing first are excellent ways of transmitting all varieties of hepatitis. If you haven't already done so, get yourself vaccinated against hepatitis A and B. Unfortunately there is, as yet, no vaccination for hepatitis C (the other viral hepatitises are dependent on you having one of the "major" hepatitises in the first place) and the treatment is extremely expensive (not much change from 100k USD, and in the UK it's limited to those with the most urgent need).

The report was worded in such a way as to be somewhat sensationalist and overstating the case. In truth there has been only a very slight increase in tenofovir-resistant HIV in a few locations. Afraid that's all the information to hand: go digging and you'll find the original report.

Knowledge is power...

Genvoya isn't actually a new drug, but the reformulation of one of its components made new approval necessary (and coincidentally extended the manufacturer's patent that bit further...). Look up stribild: basically the same drug... Let's go through it drug by drug... Elvitegravir is a new class of drug, poised to cause a similar revolution to the one caused by the protease inhibitors twenty years ago when people started recovering from aids. it's an integrase inhibitor, interfering with HIV's attempts to force its way into your DNA to reproduce itself. I've been on two of this family (only three have made it to market and the fourth, cabotegravir, is the one that's got people because of the possibility of it being used in an injectable, long life, form, but that's a couple of years from market yet. I've got a history of side effect issues and resistance issues sufficiently bad that there's nothing aside from my current regimen I can take. This includes an integrase inhibitor, dolutegravir. I've found the integrase inhibitors the easiest ARVs to take yet: my system lets me know in no uncertain terms when it and a drug don't get on and not a whiff of a problem with the integrase inhibitors. They're also bloody effective. Cobicistat is a booster: it has little if any antiviral effect. Its use is in pre-empting the enzymes other drugs need to be metabolised making those drugs wait until the cobicistat has been metabolised, with the result that the other drugs stay in your system longer. This effect was discovered in the late nineties when there were a series of deaths due to ecstacy overdose where the deceased had taken a fairly small amount: it turned out in each case that they were on ritonavir, a protease inhibitor now used in much smaller doses only for its boosting effect. The boosting effect makes it important that anyone prescribing for you knows you're taking cobicistat (for instance if you use viagra at 100mg now, with cobicistat a 25mg viagra would be ample). Emtricitabine (also known as FTC) is a nuke (nucleoside/nucleotide reverse transcriptase inhibitor) which interferes with the production of reverse transcriptase, necessary for HIV's replication. It's a pretty well behaved drug, with a low side effect profile. Finally tenofovir (another nuke) is the drug that's been reformulated: TDF is the old version and TAF is the new one. TDF is the drug that's responsible for most ARV-related kidney and bone issues. It was because of these that it was reformulated as TAF, which has better tissue penetration and required a dosage of less than 10% of TDF to achieve the same results. The kidney and bone issues have proven to be much less with TAF, though it should be stressed that with proper monitoring any damage done by TDF is reversible on stopping the drug. This means at least two kidney function tests per year and for the over 50s a regular DEXA scan to check bone density. FTC and TDF together comprise truvada, the drug used for PrEP. If it's safe enough to hand out to people to keep them HIV-, they've got to be sure of the medium term effects (we don't know the long term effects of any ARV - they're finding that out from people like me). All but one of the other combination tablets contain TDF, but with the current safeguards I'm happy about recommending tenofovir as a damn good drug that just needs an eye kept on it. I'm the 1 in 100,000 for whom tenofovir wasn't a good idea: I became seriously ill because my doctor at the time didn't pay sufficient attention to my bloods. I literally know no-one else (or even of anyone else) in the UK (and I'm well plugged in to the various patient groups) who has had severe Fanconi's syndrome as a result of tenofovir. So I'd be just as happy to recommend stribild as genvoya, and of course truvada for PrEP. The one piece of advice I would give as regards ARVs is to avoid, unless it's absolutely necessary, efavirenz (Sustiva) and the combination tablet Atripla which contains efavirenz. Many people have no issues with it, but up to 30% of people using efavirenz experience central nervous system side effects which usually show as disturbed sleep and extremely vivid dreams, which can last well into waking time so that it's like tripping. Some people enjoy the effects (free acid!), while others find them extremely disturbing. Efavirenz is now no longer used (as far as I know) as a first line therapy in the UK. If you're happy with multiple pills, the commonest combinations in the UK involve an integrase inhibitor with truvada or abacavir/lamivudine. If your doctor is thinking of abacavir it's important to be tested for the presence of the gene HLA*5701: if it's there, abacavir is off the menu as it has the potential to land you in intensive care or worse (I can afford to be flippant because guess which gene I have...). It's not unusual to shift around a couple of times with your prescription until you find the regime that's right for you: something that wasn't possible in the old days. My rule of thumb is to try something for thirty days and tough anything out. At the end of thirty days see my doctor if necessary to discuss things, then take it for another two months before making a final "this suits me" decision. Good luck...

Rather than go into a natural history of untreated HIV which you can read up on elsewhere, I'll say that your numbers sound about right for someone who's just tested positive with a two year old negative test. Probably not recently, though, as the viral load spikes during seroconversion illness often reaching 6 figures, sometimes even 7. It then drops back to a much lower level (the "latency" stage). I'm not familiar with the the QN before the PCR in your viral load: in the UK the VL test is pretty much standardised. However, whether your VL is 85k or 8k, were I in your position, rather than being nearly thirty years down the line, I'd be researching drug regimes. As long as the virus is at detectable levels in your blood it's capable of doing damage, not only by attacking CD4 cells but also by causing inflammation of your organs. Once on treatment it's the viral load that's the important marker rather than the CD4 as it was in years past. The problem with the CD4 is that it varies, not only from person to person, but from hour to hour. In fact if you go outside for a quick cigarette before have blood drawn for a CD4 test, it'll return a higher result than it would have done. It sounds like you're doing everything right, especially as regards sticking to your comfort limits. Just remember that the only stupid question is the one you didn't ask.

I have only one thing to add to this, and that's in reply to bbzh when he says: "Should an insurer/society subsidize medication for someone who is negative and could stay negative if he/she practiced safe sex?" There's no such thing as safe sex, only safeR sex. Despite all the promotion of condoms for anal sex, all those on sale in the UK at least, have been tested only for vaginal sex, not anal. People get drunk or stoned, or otherwise impair their judgment, people lie about their HIV status, people lie about their viral load, "I'll pull out before I cum", condoms break, in other words shit happens. Nothing in medicine is 100%, hence the varying figures for the efficacy of the present PrEP protocol. In practice, every seroconversion on every trial I've read up can be explained: either someone dropped out of the trial and later seroconverted, or they weren't sufficiently adherent to the medication, or they picked up HIV in the now very brief window period when HIV is undetectable in someone who has acquired it and so tested negative and were admitted to the trial. All these people, because they started the trials, are counted in the final results. However, looking at the issue from the opposite point of view: to date, no-one who has been properly adherent to the PrEP regime has seroconverted. Hence we can say that in practice barebacking on PrEP is safer sex: indeed it's somewhat safer than the same sex using condoms. If it weren't for the failure rate of condoms I would never have been born. At this point in the epidemic, with a real chance of ending it through TasP and PrEP, I'd urge anyone with a chance to get PrEP to get it and leave the pozzing fantasies to fantasy: before anyone asks, yes I've role-played pozzing both ways round. As many here can attest, real life with HIV can be pretty damn shit, no matter how hot the fantasy.

As fillmyholeftl said, seven days and you're good to go. Some guys like to leave it a little longer to be sure, but it's been shown to reach its required levels after seven days. The whole idea is that you can stop and just need those seven days to re-start, though if you're planning on stopping for just a couple of weeks, I'd say you'd be better off carry on through the "dry" period, simply because you need to develop the habit of taking it every day. Forgetting once in a while is okay (hell, even those of us using ARVs for therapy are only expected to maintain an adherence level of 95% - equating to missing meds once every three weeks on daily dosing as truvada is). If your stops are less than a couple of months, I'd suggest sticking to your prescription appointments so the blood works can be done: again, a matter of establishing a good habit. But in any case, be sure to keep your doctor up to date with how you're taking it, so to speak. The French(?) study IPERGAY is showing good results for "event dosing": two truvada a few hours before sex, one afterwards and a fourth 24 hours after that, but personally I'm skeptical of that: part of the seven day loading period is to allow the drugs to penetrate into anal tissue (it's 21 days for vaginal tissue), and if I were seeking to remain negative (29th HIV birthday tomorrow) I'd prefer to be on daily dosing: I've often not had the 2 or 3 hours warning that I was about to get laid, it's just happened If taking a truvada is something you just do after you've brushed your teeth in morning, or whatever daily event you've chosen to link taking truvada to, then you don't need to be worrying about taking it in time, or having it with you...

There is still a possibility of getting PrEP. You'd need to check the local situation as regards importing prescription drugs for your own personal use and the possibility of getting the necessary blood and STI testing done. Check with the site http://www.iwantprepnow.co.uk/- although it's written for the UK health system, it shouldn't be too difficult to translate between the NHS and the German health system. It really is worth the trouble: I know because I'm living with the virus and though it can be very, very hot in terms of fantasy, the reality isn't worth it.

The cobicistat in stribild acts to delay processing of some drugs (which is why it's there - as a boosting agent, so you don't have to take meds so frequently or in such quantity). It acts in prety much the same way as rotonavir does, blocking the main pathway in the liver that's used to metabolise some drugs, including the ED drugs. Medical advice in the UK is to start at a quarter of the standard dose of the ED drugs and if that's not enough I know some guys who'll add an extra eighth of the standard dose. The trick is balancing an good hardon against the side-effects of the ED drugs: no-one needs the sort of head pain I had when I inadvertently took a full strength levitra! Standard dose for viagra is 100mg every other day and for cialis 20mg a day. I can't remember for levitra, I'm afraid. So you'd be looking at 5mg cialis or 25mg viagra. But for fuck's sake be careful with the poppers: they're best avoided by anyone using ED drugs as you're effectively taking two drugs that work on the blood pressure in different ways and to different ends.

All of the ED meds are affected by ritonavir and cobicistat which, although they have an anti-HIV effect in themselves, are far more useful as boosters to stop other drugs being metabolised too quickly, thus raising the half lives of other drugs so you don't have to take them so often. For this reason, in the UK at least, viagra, cialis and levitra are prescribed in much smaller doses for men taking ARVs. The effect of ritonavir of blocking the P450 pathway in the liver was first noticed in the UK when guys were dying of ecstacy overdoses when they'd taken nowhere near a fatal dose: these guys were also taking ritonavir (then prescribed at 600mg to 800mg a day: a massive, damaging overdose). Around that time I'd been given a twentyfive quid wrap of charlie as an xmas present, so I checked with a very professional, obliging pharmacist who told me that if I were to take something like charlie I should be aware it was likely to be cut and her estimate was that I should only take about a quarter of the amount I'd normally take. All delivered in terms of "well, if one were to do this" so she could plead she was answering a theoretical question! Ritonavir is part of my prescription and I find that viagra is the safest for me (the other two cause migraine-like headaches even at their reduced doses): after some experimentation I found that 25 to 37.5mg (the tabs I get are scored to make them easier to break in two) is my ideal dose: any more and I'm in the wrong sort of pain afterwards. ED drugs are also useful for bottom who want to try fucking but find that they can't. My FB was in that position until he swiped one of my viagras one night and woke up with the hardon from hell. A long time since I've been woken up like that...

In the late seventies when I worked with what was then London Gay Switchboard, we had a policy of reminding male callers to have a checkup for STIs every three months "whether you think you need it nor not", and also to hightail it to the clinic at the first suspicion that there was something awry. Guys who are more erm... popular might want to make their clinic trips more frequent. Remember that a number of STIs can be totally or near-totally asymptomatic: especially in the ass or throat. Doesn't mean they're not there, though. In 1980 I went to the clinic with a rash that I thought was secondary syphilis (the initial chancre, I reasoned, would have been up my ass where it went unnoticed. Years later we figure out it was seroconversion illness. Making clinic attendance regular and "whether you think you need it or not" is one thing from the seventies that needs to be revived. It's worth noting that condoms aren't necessarily a help in stopping STIs: some (eg syphilis and herpes) can be transmitted by mere skin contact. And everything you can catch up your ass you can catch in your mouth (except the chances of HIV, whose transmission is practically zero by this root, and I still look sideways at claims of oral transmission: too often they're part of "nice boys don't take it up the ass") Difficult to tell who's got what (and they very often don't know themselves), so any sort of sorting on the basis of looks/recent experience is pretty pointless. Rely instead on regular testing and immediate treatment - and if you're prescribed antibiotics, take the full course. The idea is to get every last microbe dead, rather than just to free you of symptoms, which happens well before the treatment is finished.

The advice at www.iwantprepnow.co.uk is geared to the UK, but it shouldn't be too difficult to translate to the health system of another country. As berlinboi says, the testing is the essential part of the PrEP programme: getting the generic drug is the easy part. I'd urge everyone to make damn sure they stick with the testing side of the programme: STIs can make it easier for HIV to establish a bridgehead in your body, and if there's ever going to be a documented case of someone getting HIV while fully adherent on PrEP I'm betting that there'll be another STI involved. The HIV test is essential because if you forget too many tablets and do pick up HIV, then you need more than just truvada or its generic to deal with it: truvada is not enough in itself. Finally the liver and kidney testing are essential: if you're going to have problems with the drug (which is extremely unlikely: everything I see says that neg guys have it easier than poz guys with truvada), these, and your bones, are where the problems will manifest. It takes a long time and a negligent doctor for problems to happen, but it can happen. The odds are on a par with hitting the jackpot in the UK lottery, but, gentlewhores, I hit that jackpot. Trust me: jump through all the hoops the doctors tell you to. And if you're in the UK, I've heard so much good about 56 Dean Street... If I lived in London I'd be using it.

I'll let you know when I find out

Sorry, but I don't see this working largely because you're presenting a huge new vocabulary using the syllable "poz" so often that it loses its meaning. The way, to my mind, to jolt someone is to throw in an outrageous idea at treat it as normal, but to do it sparingly. I once reviewed for Amazon a book called "Bugz" which fell into the same trap: it used the letter "Z" so frequently and unnaturally that it became meaningless...

Banned4Good could be a go: http://www.theguardian.com/technology/2014/oct/01/victory-drag-queens-facebook-apologises-real-name-policy

What you have to remember after what hairyone said is that he's talking about 2003: one hell of a lot has changed since then. So much so that I always advise people to check the date on a page and if it's over six months old its "news" is probably already history. By 2003's standard, hairyone, you were undetectable within three months as the line was between 400 and 500 at the time. Within a month, he's probably got to the point of being merely "mildly" infectious, but you've no way of knowing that. As hairyone says PEP is available, but it needs to be started within 72 hours of the potential exposure. There''s a sharp drop in its efficacy after 48 hours, so time is of the essence. If you're somewhere where PrEP is available, that's something you might want to consider for the future. If PrEP isn't "officially" available to you, this site may be of help: http://www.iwantprepnow.co.uk/. Although it's a UK site, it shouldn't be too difficult to translate to the health system of your country.

How about plastic or rubber sheeting with thin towels or something else softish (hell, even the t-shirts and such due to go in the machine!) under the edges to raise them up slightly?

Hate to rain on your parade, but any active virus in the cum would be long dead by the time you got to play with the condoms, so this scenario would be entirely symbolic...

I've seen a post from one of the guys behind iwantprepnow saying that the outage is a temporary glitch: as of 9am (BST) they know what's causing it, and are working on fixing it...

www.iwantprepnow.co.uk has just launched... should be worth a look

I've literally in the past few minutes had the announcement of the opening of www.iwantprepnow.co.uk which goes into detail on what PrEP is, what tests you need, and, most importantly, how to get it in the UK. It's a bit rough and ready at present, but the information is there...

When I first pitched up here I was working in HIV prevention and my aim was to understand the chasing mindset. Basically, you can't, any more than explain to someone who's not into drag the delights of a garter belt and stockings (something a FB of mine was faced with recently: he shut his eyes and thought of Wales while getting pounded, but that's another story). PrEP, of course, rules out the inevitability idea. Even in the UK, without government approval, we're talking about how to get tenvir-EM, which hospitals will do the testing outside of STI/HIV testing that's necessary, and the whole concept of clinic hopping. Finally I'm not telling people obliquely "message me privately"... Very, very few HIV- men can't tolerate truvada (and there are other drugs in the pipeline) and the chances of meeting a guy with an infectious viral load whose virus is resistant to both tenofovir and emtricitabine is vanishingly small. While I, as a long term survivor of HIV, still can't claim to understand the chasing mentality, especially in the light of the tool we now have in PrEP to avoid infection, so condomless sex is safer than it has been for more than thirty years, you can't deny that a few people are still chasing. It's a threat that's become eroticised, but one which falls down with the progress we've made against HIV. I even wrote fiction to try and get inside of the mind of a guy who was chasing, and fell down in that I couldn't. Get into his mind, I mean. For those who feel that getting HIV is inevitable, the attitude of wanting to know who it was who gave them HIV I can understand: somebody fucked me in early 1980, I seroconverted and would dearly love to know who it was just to know if his luck held as well as mine. The preservation/passing on of DNA plays into the daddy idea here as well. Hepatitis C is different in that it's seen as an acute illness, even though it can show very few symptoms, if any, for a fairly long time. With HIV there's always the chance element. I know guys who were infected after me who died within ten years (my two life-partners did), whereas I personally know someone who was infected before me, and via facebook know guys in the USA who were infected before me. Finally there's the taboo element: "nice" boys don't do the sort of things that you can catch HIV from. Just yesterday on Facebook I read a reference to "the biohazard and piggy crowd" and it definitely wasn't meant affectionately! HIV has been around long enough now to have shaped our entire way of thinking about sex, giving us new ways of rebelling against "cultural norms". That, if nothing else, is an argument for why the Breeding Zone should be here and why I still recommend Tim Dean's book "Unlimited Intimacy" (so much so that after the paperback I went on to buy the ebook), even though it's over ten years old now.

In a word: no. It might not have been mononucleosis, but if it was HIV it wasn't from that encounter. What I'd suggest you do is adopt the sexual health strategy we used to use before aids which was to have an STI checkup every three months whether you think you need it or not: many STIs you don't necessarily have symptoms with. Have an HIV test at the same time and depending on the result, either get yourself on treatment or on PrEP.