srider

It can be really hard to parse all of this out as a clinician. Often if something happens, unless there is a reversible cause it generally doesn't matter the specific reason for cognitive decline. 

Keeping your VL down is your best bet. 

Is he poz?

Andy star

Nate grimes

Drew dixon

John thomas - love to play with him. 😈👊🏼💦

Thank you! 

The bottom is super fucking hot - I wanna see other vids of him

[think before following links] https://privatehomeclips.com/videos/7749571/beautiful-bb-ff-couple/?promo=31134

I hope you are doing well now! Neurosyphilis can happen at any stage, but is more common at the late latent. People living with HIV are also more likely to get neurosyphilis. 

I also agree that I wouldn't take doxycycline for 14 days after each exposure. There is some evidence of smaller doses of doxy post-sex as prophylaxis for syphilis and chlamydia (not gonorrhea) but this may drive antibiotic resistance which would fuck everyone over. If you are engaging in activities where you are at risk of contracting STIs, testing is the best strategy. 

On 10/13/2019 at 9:34 AM, CuriousDallas said:

I had a problem with nausea when I first went on it but found weed helped. I’m on my parents insurance and can’t have them find out I’m on it so I get it shipped to me from Mexico as it’s cheaper. As a result I don’t really have much of an ability to adjust meds or really be sure it’s working right like if I was doing it in consultation with a doctor. I haven’t been tested since going on it but other than the nausea I feel pretty good. I get fatigued sometimes and have insomnia sometimes too...not sure if that’s the meds or something else

That could be life causing fatigue. However, make sure you test for syphilis regularly. 

This is low risk high anxiety. Often related to feeling guilty for what was done.

If you're going to have sex with men, go on PrEP. Also don't lie to yourself about what you will or won't do. 

1 tablet daily dosing is the most effective, missing the occasional tablet is okay. 

PrEP on demand is also an option, depending on sex habits. Trials have shown lower efficacy than daily dosing though.

Truvada is not currently used for HIV treatment, unless combined with another drug. Most people will go on something Biktarvy or Genvoya. That is why it is important to test regularly while on PrEP to prevent resistance if it fails (e.g. strain resistant to Truvada, inconsistent adherence, etc.)

The recommendation is to treat LGV contacts for LGV. Hassle Free Clinic will likely receive the test results for chlamydia and the LGV strain shortly. You can follow up with them. Call and ask to speak with the Public Health Nurse and they can advise you whether you need to finish the antibiotics.

It will be interesting to see what the recommendations are. I am surprised gonorrhea was reduced by doxycycline as the strains that are circulating often have high resistance to doxy. There are concerns that it could also continue to drive antimicrobial resistance. 

"Doxycycline prophylaxis for bacterial STIs shows promise. Better and more robust data are needed on efficacy; target population; community acceptability; behavioral risk compensation; doxycycline dose, regimen, and formulation; long-term safety; antimicrobial resistance; cost-effectiveness and risk-benefit."

16 hours ago, Grey said:

If you consider eating ass to be sex, then yes, it's transmitted sexually. The virus is transmitted via oral exposure to infected fecal material -- even a microscopic amount. It stands to reason one could be exposed to it as a result of licking around down there.

Men who have sex with men are at increased risk for Hep A (and other parasites) even if they don't rim. The faecal-oral transmission can occur from just plain anal sex, especially without condoms.

3 hours ago, wildbottom said:

If you haven't had any type of Hep, you should get a Hep A vaccine and a Hep B vaccine. You should also get an HPV vaccine and an pneumococcal vaccine (covers mono and others).  Hep C has no vaccine, is sexually transmitted and has an 18-20% full recovery rate (ie, stays acute then you're immune). If it becomes chronic there's a cure but it's expensive.

And, studies are showing that a 100mg pill of doxycycline before sex reduces the chances of syph, gono and chlam by up to 70%

However, using doxy that way is also driving antibiotic resistance in gonorrhea. Many gonorrhea strains are already resistant to doxy as well.

Usually the side effects you're describing are self limiting and resolve themselves. However rarely they won't go away. You could try for a bit longer and see if it gets better. The other thing is you really should be monitoring your HIV status and bloodwork while you are on PrEP.

Depends on the test, like wood said. Hep C could take up to 6 months to show on blood tests though. 

It is quite treatable now. Also it's possible to get it from inhalation substance use (e.g. sharing straws/keys/popper bottles) not just injection drug use or raw sex.

Every three months is a good frequency for many guys who are sexually active. If you have multiple partners a day/week you could consider every 1-2 months or additional tests when you are symptomatic. There's no right answer, but don't go much longer than 3 months if possible if you're quite sexually active.

Nurse here - less than 200 copies is virally suppressed. If someone has a blip in their VL I'm not concerned. I consider less than 200 to be almost synonymous with undetectable.

It is less effective than daily prep. If cost or side effects (actually having them, not fear of them) are an issue, or someone's sex pattern is very infrequent (e.g. 1-2 times/year), it could be an option for people.

For any trans men, it is not effective for frontal/vaginal sex as the genital tissue does not absorb the drug as well as the rectum.

20 hours ago, BiAthlete4You said:

There are 3 sexual epidemics in San Francisco right now, one of them is Hep C.  Its the last thing I need. Probably worse than HIV, because I am a man that fancies a drink, and I don't want my liver getting fucked up from Hep C.

I'm quite curious to know more about this. Where is info being shared?

1 minute ago, Ranger Rick said:

I do not understand this sentence in this context. 

Frontal = vaginal, but not describing it in terms of female genitalia. 

Hep C is mostly transmitted through IV substance use or shared inhalation equipment. There have been some documented sexual transmissions. It is usually treatable.

Herpes - you probably have it and it never caused an issue. It can be transmitted skin to skin before symptoms are noticed. It's not thought to be controllable by public health. If you get it, take meds or it resolves on its own. It may come back, but your body becomes better at clearing it.