Poz1956

PM me the name of that clinic, and I'll write a letter of complaint. If someone asks about PrEP, because they ARE taking risks, it IS the clinic's JOB to be neutral, and present factual information. For that matter it is their job to discuss ANY HIV prevention method on which the client requests info, even one's they don't endorse. (Bet you they'd wrinkle their nose at "serosort to undetectable" too.)Health Canada has not approved Truvada for PrEP, because Gilead has not even applied for that approval. Doctors CAN and ARE prescribing PrEP as an off-label use. In Quebec it is covered by the provincial drug plan (the only province that has that). The co-pay is $80 a month. I know someone in Toronto who has it covered 100%. Out here in Alberta, an friend recently picked up his first batch of Truvada. His drug benefit plan, through work, covers 80% for all meds. I believe he said his co-pay is $200. Next time we talk I'll ask if that is per month, or per refill. As part of your decision process, check if your drug plan will cover it, and how much is the co-pay. Most people tolerate Truvada very well. Some experience headaches in the first weeks. Some have an upset tummy in the beginning. But those go away. Any potential kidney or liver problems would be caught by the tri-monthly tests. Any "damage" done during the three months since the last test, reverses itself when the drug is stopped. The only way you'll know IF you'll have side effects is to try it. If you have a reaction - stop. You also need to ask yourself, which is going to have potentially worse side effects, PrEP or a three drug HAART regime. There is a commercial getting heavy airplay that sounds exactly like this discussion. The guy refuses to taste an almond flavoured Soy beverage, because he doesn't know what it will taste like. But he can't know how it tastes, until he actually drink some. In the end, he has a glass, and likes it. When my CD4 count was very low, they gave me antibiotics as a prophylaxis for PCP phenomena. How is PrEP any different? If you were travelling to Africa, you'd get shots for malaria, wouldn't you? You've had shots where they put dead bacteria and viruses into your body. (That's what vaccinations are - right?) If looked at from that perspective, don't vaccinations sound extreme?Have a PM or phone chat with some of the guys here who are on PrEP. Read Jake Sobo's "My Life on PrEP" blog, and his "Promiscuous Gay Nerd" articles on the Beta Blog. I know it sounds like we're pushing. It's because we care. Several of us have spent a lot of time talking to newly diagnosed guys, trying to calm them down. All the Canadians on this message board should to start pressuring Gilead to extend their co-pay program North of the border. Yes, even if you're Poz, or never have any intention of taking PrEP! We NEED to harass them at a corporate level. I don't know if their US co-pay assistance program phone number works from Canada - but it's worth trying. Their assistance program website says "The Gilead Co-Pay Coupon Card is available only to residents of the United States or the Commonwealth of Puerto Rico. If you would like to discuss further, please call 1-877-505-6986." We DO want to discuss it! We must phone, email, and send good old fashioned postal mail to Gilead's Canadian head office too. Gilead Sciences Canada, Inc. Suite 600, 6711 Mississauga Rd. Mississauga, ON L5N 2W3 Canada (905) 363-8008 or (866) 565-5409 Canada_info@gilead.com Maybe some of our American buds, especially those already on PrEP, should call the US number and say you've extolled the virtues of PrEP to a Canadian friend, but he can't afford to get it because of the insurance deductible. Ask why they don't offer the same deal you received to Canadians. Your Canadian friend needs protection from HIV too. A little grass roots movement can only help. If we don't make a fuss, Gilead won't take any action.

So you live in one of those states that during the AIDS panic of the 80's passed laws, which were really nothing more than legal stand-ins for homophobia. Some of those law are so poorly crafted that there are Poz people in jail for spitting. The Global Commission on HIV and the Law recommends “Repeal punitive laws” and “Enact no laws that explicitly criminalise HIV transmission, exposure or non-disclosure of HIV status” as they are counterproductive in the global fight against HIV. As others have stated, laws criminalizing non-disclosure do more to spread HIV than to knock back the epidemic. They cause people not to get tested. If a guy doesn't know his status, he can't be charged. Criminalizing non-disclosure doesn't make it easier to discuss HIV status. It makes it a LOT HARDER. Personally I don't think any Neg guy can fully understand how difficult disclosure is. We learn very quickly that while people claim to want honesty, they immediately punish us for being honest. The responses can range from the extremely RARE polite "Sorry, I'm just not comfortable", to histrionics calling us murders and sociopaths, and even violence. I got set up for a bashing as a result of pre-meeting disclosure to a guy I'd chatted with for several months. There is a HUGE internal tug-o-war between the moral "I should reveal my status" and quite justifiable fears about which kind of response will be received. Over 50% say you will NEVER knowingly sleep with a Poz guy, and another 20% to 30% won't agree with Never, but say No when faced with the situation. In places with those stupid laws, you have to add the fear about potential legal implications of disclosure. One of his thoughts is "how do I prove I disclosed," because these things turn into "He said / He said." The Poz guy is always presumed guilty, while the Neg guy is always a sweet innocent victim, regardless of no transmission occurring, or if they were ever at any risk. Wherever these laws exist, "Neg" guys seem to have an extra sense of entitlement. They have an higher level of "assumed negative" in their suroguessing games. These laws add more fairy dust to the magical properties of "Clean UB2." Guys step further away from accepting personal responsibility. If they even hear of a transmission, the first reaction is indignation and "call the cops." It's really visible in any online forum that discusses Poz/Neg BB sex, for example the chatter about the Partner study, or an article about the challenges of disclosure. Some commentator will say he caught HIV from a boyfriend (estimates are the +33% of new infections in the US are from men's primary sex partner). Several comments follow with "He should be charged," and "inform the authorities." Yes, maybe he did have a laps in judgment. You feel that the other guy committed a crime by not disclosing his status. That may be true in your jurisdiction. It certainly isn't everywhere. For a little context read Mark S. Kings When People with HIV Became Suicide Bombers. But your accessing his private medical information, for your own personal use IS a crime in MOST places. Frankly, you should be fired and charged! You could probably also be sued. Make no mistake about it - YOU COMMITTED A HUGE ETHICAL AND MORAL ERROR! You might have gotten some of the sympathy you were looking for, if you hadn't admitted to illegally accessing his medical records. Most Poz guys are fed up with juvenile questions like "Clean?" And some of us are sick of it to the point where we will answer "Yes." It is a vague question with a number of possible meanings (as I mention in point 4 of this post). Just because you pretend clean only has one meaning, doesn't make that true. If you're not mature enough to actually discuss HIV, maybe you shouldn't be having BB sex. If all you asked what his status via a childish "Are you Clean" question, you didn't have a real discussion of sexual health. The first question should be "When were you last tested" along with "How often do you get tested." I'll stack a Poz guy's four month test cycle up against most "Serostatus Unknown" guys. Half of "Neg" haven't been tested in over a year and 25% have NEVER been tested. The numbers are even higher in the under 25 group. Most "think they're Neg" will assure you they are "clean" regardless of how long it's been since their last test, how many loads they've taken, or how many holes they've pounded. Lets see - you're at three months since that hook-up, and you haven't had a full STI screening. You're barebacking. You're sitting there with two other guy's loads in your ass. The best recommended practice is testing every three months. You'll be required to get checked that often on PrEP, but clearly you weren't doing that before. I've always personally felt that disclosing my status was the morally correct thing to do. Unfortunately I've received so many uneducated, morally corrupt responses, and seen so many ignorant depictions of Poz guys, I now find it challenging to reveal my status. You asked "WTF is wrong with people?" Maybe after being bludgeoned tens of thousands of times with "Clean" "D & D Free" "Healthy" "infected," "Diseased" and all the other radioactive "Not Me" language, he just broke. WTF is wrong with all you guys who use that dehumanizing language? WTF is going on in your brains, when you can't even be polite if a guy reveals his status? WTF is up the attitude of moral superiority for simply being Neg, and slut shaming of Poz guys? And WTF is wrong with all you "might be Neg" guys who have a totally irrational level of fear about HIV? Evolve beyond a simple minded "fight or flight" response. It's not 1984. You're here, so you have access to the net. Spend a little time reading something written about HIV in the last few years - like TasP (Treatment as Prevention), the Partner study, or even the older HPTN 052 study. Personally I can't wait until the final reports from the Partner 2 and Opposites Attract studies are published. There is a certain irony in the fact us Poz guys, who you Neggies loathe, and immediately reject, are turning out to be the ones least likely to infect you! Won't it be a bitter pill for you and your "clean" brethren to swallow, when you realize that the epidemic is almost entirely driven by the exact behaviours you thought protected you.

HIV information sites are littered with statements that having another STI will make you more vulnerable to HIV, and that it will spike a Poz person's viral load making him/her more likely to transmit the virus. It's certainly logical and feasible that SOME types of STI that create sores and major inflammation would make someone more receptive to HIV. Logic dictates with HPV the susceptibility would be only at the sight of an outbreak. But I'm not sure a wart creates the conditions that would increase the chance of infection. Of course we need to add viral load to the discussion. Both a newly infected guy with a viral load of several million, or chronic infected guy with 30,000 to 120,000 have great deal more power to Poz, than an undetectable. The Partner study may call into question the old trope that All STIs create and increase susceptibility, and that all STIs spike the viral load. Remember that 16% of the gay couples had STIs caught from outside playmates. None of Poz guys had a spike of their viral load. None of the Neg guys caught HIV from their Poz partner despite both of them having an STI.

I reached out and will communicate with him off-site. I am part of a group of Poz guys who offer one-on-one peer support to the newly diagnosed. I will probably talk with him sometime tomorrow. I'll report back with my assessment of extremely scared guy with very little knowledge of HIV, or brain dead twit trying to wind us up.

Most of you are probably too young to remember this, but before HIV, Hep B was the thing gay men feared. Because it was so common in the gay community, blood drives were held targeting us, so they could collect the antibodies for Immune Globulin. There were also vaccinations campaigns. Early in the GRID/AIDS crisis, some feared that what we now know as HIV might be transmitted in the vaccinations. (It wasn't) Conspiracy theorists claimed the government was engaged in germ warfare experiments, by infecting they gay community through the vaccination campaigns.

That's not quite correct.From the CDC website: Immune globulin is available for short-term protection (approximately 3 months) against Hepatitis A, both pre- and post-exposure. Immune globulin must be administered within 2 weeks after exposure for maximum protection. Immune globulin contains antibodies taken from donated human blood. It is used as Post Exposure Prophylaxis for Hep A, and as a form of PrEP when you are travelling to a place where Hep A is common, and haven't previously received vaccinations. (PrEP is a generic term -- Pre-Exposure Prophylaxis -- a preventative before you are exposed to a contagion. All vaccinations are a form of PrEP. Out community has co-opted the term as a short hand reference for "Truvada used as PrEP against HIV." Eventually there will be additional drugs available for PrEP against HIV. The term PrEP can be used in other contexts that have no connection to HIV.) A vaccination causes our immune system to produce its own antibodies for the specific disease. From the CDC website: How long does protection from Hepatitis A vaccine last? A recent review by an expert panel, which evaluated the projected duration of immunity from vaccination, concluded that protective levels of antibody to HAV could be present for at least 25 years in adults and at least 14–20 years in children.

Testing for Hep B and offering a Hep B vaccination are supposed to be standard operating procedure before prescribing PrEP. I think your doctor made an error if he missed those steps. Even if he believed you to have previously received the vaccination, the strength of the immune response can be tested, and it should have been done. Perhaps give your doctor a gentle reminder, in case other patients discuss PrEP with him. (Checklist for Prescribers) One of the drugs in Truvads is used to treat Heb B. There has never been a study on using its use as a prophylaxis for Hep B, but I'd guess there is a pretty good chance it could work as a preventative. For everybody else, ALL gay men should have the Hep A and B vaccination. Hep A is spread by fecal mater. Many gay men rim. Therefor gay men are at higher risk of Hep A. Hep B is sexually transmitted, and quite common in the gay community. Hep B is 50 to 100 times more transmissible than HIV, and is definitely considered possible to transmit vial oral sex. Therefore ALL gay men should have both those vaccinations. I wonder what would happen if we polled all those "Clean UB2" guys, and asked if they had been tested for, or vaccinated against Hep A & B. I'd bet the response would be a vacuous stare.

Sometimes when I'm feeling horny my status line on a hook-up website reads "Probe me with your one eyed trouser trout!" I usually refer to mine as my Cock, or Dick. If I've used the others too much, I resort to Pecker.

Your current drugs focus all their protection on one element of the HIV reproduction cycle -- reverse transcriptase. Your doctor's suggestion is to spread it out over two parts of the process - Reverse Transcriptase and Integrase. Conceptually I like that idea. Then there is the additional point that Integrase inhibitors tend to achieve high concentrations in the genital track. That has the benefit of greater protection against onward transmission. Ask your doctor. I'd be willing to bet those are exactly her reasons for suggesting the switch. Remember that because you haven't developed resistance to Efavirenz (Sustiva), its not "off the list" for the future. You could always go back to it if needed.

Also if your insurer requires that you get Truvada from a specific pharmacy, it is likely your insurer is paying way less than the retail price.

The reaction seems to be common. Jake Sobo in his piece titled "Wishing and Hoping and Praying—How Not to Prevent HIV" described the exact same reactions. You could try and explain to these guys that 83% of new infections are from guys who think they're "clean," and that you're trying to prevent one of those "surostatus unknown" guys from infecting you. These mental midgets probably wouldn't be able to grasp that concept either. Because they "know" they are "D Free," the information couldn't possibly apply to them. But as others have said, just take you pill every day, call yourself "Neg," and mention that you get tested every three months. Most will be very happy with that info. Leave out the fact that you're on PrEP, because it just confuses those with uneducated grey matter in their big head. And of course these responses run completely parallel to the reaction a Poz guy gets when explaining the low risk of an undetectable viral load. I wish we could figure out a way to cut through all this crap so we could all get back to the serious business of having happy, fulfilling sex lives.

What bothers me most about posts like these is the mental attitude. A "Neg" guy is HIV Negative until proven otherwise. I their own mind, they delude themselves into thinking "As long as I don't actually have a Poz result, I can think I'm Negative, and advertise myself as Clean." For an experiment, ask each one of your "never tested/long time since tested" friends if they would ever have "safer sex" with a Poz guy (Not a question for the hard core barebackers of course). I'd bet they'll scream "Ewww - Ickkk - NOOOOOOOO!" and run away with wrist flapping like butterflies. There are several studies showing 46-54% of of guys agree they will NEVER play with a Poz guy. I was reading a UK study that had an interesting additional statistic. For guys who had never been tested, it was 68% who would always refuse someone who knew his status. I wish some survey would ask a follow-up question to the guys didn't agree with "Never." What situations would they? I'd bet 20% or less would be completely accepting of Poz guys. The rest would parse it out to "only if I loved him," "he was incredibly hot," "I felt the desperate need to just be held by someone that night" or other minimizing situations. In my experience, most guys who wouldn't agree with "Never," will turn down a Poz guy when actually faced with the situation. Of course most guys who think they never have and never will sleep with a Poz guy, are only fooling themselves. They probably already have, in one of those "status never discussed" situations. Perhaps they've even fucked around with another "Negative until proven otherwise" guy, who wasn't as "D Free" as he thought. And with the growth in new infections and predictions of 50% of 22 year olds becoming Poz by the time their 50, if they haven't played Poz yet, they will. Lets just hope when they do hook up with a Pozzie it is a guy who was responsible enough to get tested, responsible enough to seek medial care, and responsible enough to take antiretrovirals. Or maybe they'll be lucky, and dodge the bullet on those occasions, because not every raw fuck with a high viral load Poz guys results in transmission. It just gets me really FUCKING angry that guys who are don't know they are Poz are responsible for over 83% of new infections, but Pozzies who got tested because they cared about their own and their community's health, receive 100% of the blame for spreading HIV. For the "I don't want to get tested" crowd, ask them when they'd rather find out. They could do it now, while their immune system is intact, and treatment will let them live a normal life as a Poz guy. Or they could wait until they're sick in hospital, with a permanently damaged immune response, and get a "surprise" diagnosis of AIDS. Local data had some of them die within seen days of diagnosis. Why can't these guys behave like adults, and grow a pair? It's time we started slut-shaming the men who don't get tested. THEY ARE DRIVING THE EPIDEMIC!!!! The "I'm too chickenshit to get tested" attitude, is exactly why Poz guys under treatment are now predicted to outlive the average dude. "Neg" guys will put off going to see a doctor about any medical condition. WDS82, why not trick your friend. Set up a date to do something fun (during hours when the GUM clinic is open). You make the appointment for him and yourself. Then drag him there. Plan some fun stuff for afterwards.

Great news.As you probably know the definition of Undetectable is that the viral load is below the threshold the test can measure. What number used is dependant on the test. The most common in North America is below 40. In the UK that seems to be 50. The test used in the Partner study use >200 as the their descriptor of UD. With the newest test, undetectable is below 20. Looks like you've got results from that one. I'm going to suggest playing it safe for a few more months. You've only been on the meds for three months. The best recommendation for guys selecting an Undetectable Pozzie is that he's been UD for a minimum of six months. I can take a little longer to reach undetectable in the seminal and rectal fluids than in the blood plasma. That six month suggestion was set by the research that led to the Swiss Statement in 2008. The longer you maintain an UD viral load is the greatest predictor of you continuing to remain undetectable into the future (assuming med adherence etc). But reaching that milestone is defiantly worth a celebration. Maybe a new Nasty Pig jockstrap, or a Cum Guzzling night at a glory hole.

Please explain the "positive" outcomes - the good things, you expect as a result of becoming HIV Positive.Why not go on PrEP instead? I'd be willing to bet that it would give you all the imagined benefits of being Poz. The main downside of PrEP is an increased frequency of blood tests and doctor's appointments. But you would have those if you became Poz. In a sense, PrEP gives you all of the inconvenience of being Poz (daily drugs, blood tests, doctor appointments), without actually being Poz. But with PrEP you actually manage to avoid the Stigma, and other life complications of being Poz.

I know you mean no offence, and that you're just happy that your test came back Negative.Just be cautious about what language you pick. Why use a simplistic, non-specif term? Are you afraid to say HIV Negative? If you want to state you serostatus clearly, say " I tested HIV Negative on May 21, 2014." If you're "clear" does that mean I'm Foggy or Opaque? "Clear" boarders very closely on the dreaded "Clean" that so many "Might be Negative" guys use. Since they're "Clean," all us Poz guys must be "Dirty," right? I know it sounds like semantics, and like I'm being overly sensitive. For just one hour, pretend you test came out the other way. Spend that hour reading hook-up profiles. At the end of that hour, give some thought to how innocent "Clean," "Unclean," "Healthy," "Unhealthy," "Diseased," "Infected," "Turn Offs," and all the other "Not Me" language feels. Now think about reading that kind of shit for 28 years, like I have. I AM glad your test came back Negative. I truly am! Despite the talk you see elsewhere on the board, one of the biggest fears most Poz guys have, is that they might pass the virus on. It turn out that with an undetectable viral load, we basically Can't transmit HIV. But if you ask the average "Serostatus Unknown" guy, most are 100% certain that guys who know they are Poz are responsible for all the new cases. When in truth a UK and a US study showed about 54% of new transmissions are from guys who caught it between a couple of weeks, and three months ago. About another 30% are from guys who have had it longer, but haven't been tested, so they don't know they are Poz. The best recommendation is that even IN a monogamous relationship, you should get tested at least once a year. There is a fair bit of evidence that being in a "monogamous" relationship is fairly high risk for HIV transmission. That's not about lacking trust - that's just what the numbers are showing. If you haven't had the explicit "negotiated safety agreement" discussion with your partner, perhaps it is time. Some testing centres and HIV service organizations offer couple counselling to facilitate that discussion.

As I pointed out, Health questions ARE included for Mortgage insurance WHERE I LIVE. It was AN example. One of THOUSANDS I could pick. But the BIGGER point is, HIV has a shitload of unintended consequences. It's not JUST about sex. As far as sex goes, being Poz gets you LESS sex. The majority of "think they're neg" guys will immediately reject you. PrEP is a much better option, than deciding to become Poz.

Don't "say." Don't guess. Be responsible enough to go get tested.If you test Poz, get on treatment ASAP. Once you're undetectable, If you test Neg, get on PrEP. THEN you'll be fro to become a complete cumslut. Right now, you're just paying Russian Roulette with your own health, and the health of the guys fucking you.

I suppose with the OraQuick test available in the USA, that strategy is now a realistic possibility in your country. Bought in groups of 3 they’re about $25 per test, making it $50 per evening of fun. I very much doubt many will adopt that approach for for a phone app or online hook-up. And what do you do during the 20 minutes while fretting and waiting for the results? Neck maybe, but not let it get hot enough to loose track of time, or move on to the main event, before the test results are in. Defiantly set an alarm so the results don't unchecked in time. For a ASAP connection, I would truly fear for the mental, and physical heath of the guy who discovered his Poz status in that situation. The other guy would probably kick him to the curb, or run out the door if the newly discovered Pozzie was the host. And based on my personal experience when I have revealed my status, there would be some pretty nasty assertions made about his moral character. There is the possibility of the Neg guy turning violent. While the kits include a 1-800 number to call for post test counselling, would the man who ejected the newly discovered Poz guy even give him that info? The mindset would be totally different than an individual having chosen to test privately in his own home. Someone taking his own life, could be a possible outcome for in home testing with all tricks.

There are multiple reasons for the "use PrEP with Condoms" message. When the drug was in trails, they were unsure how effective it was. Advising people to take precautions, was wise, and ethical. Heath providers by their nature are very conservative. They are very worried about the spread of other STIs. Advising the use of a condom, is their standard operating procedure for prevention of STIs. (Of course pre-HIV they didn't make that reccomendation.) It is virtually impossible to prove that something is 100% effective. Statistical confidence intervals always leave the possibility that the results observed so far are just random chance. Because there is a remote possibility of Truvada for PrEP not working, again the medical SOP would be "make sure there is a back-up plan." Since Safer Sex campaigns got rolling in 84 (and not really mainstream until 86), "Condoms, Condoms, Condoms" has been THE most important message. The powers that be are very comfortable with that refrain. (Funny how they were very uncomfortable with it in the beginning.) It's hard for them to change the paradigm they have grown to love. Add the conservative nature of politics in the US. For example, the CDC is still forced to have the "Abstinence is best," message in their HIV prevention pages, though thankfully no longer the first item on the list. And again, there's that STI thing, and the desire to prevent their spread. The CDC isn't stupid, and they understand the reality of what's happening on the ground. They know how much condom use has fallen off. They are seeing the continued rise in new infections. Their mathematical modelling is producing frightening numbers. They need to be proactive and try and prevent the worst outcomes. Hence the CDC has put forward their statement. It really is a big deal, and huge step, for them to face the right wing backlash by highlighting PrEP. The CDC is being bold, and we should applaud them for that. And finally, in the US, there is a legal environment where you can sue the vendor, because you spilled your hot coffee on your crotch. The coffee was too hot, and you can convince the jury that the vendor was negligent, thus winning the legal lottery, and walking away with tons of cash. Because PrEP can't be proved to be 100% effective, condom recommendations are a "cover our ass" prevention for lawsuits. I come from a place where healthcare is very different. Funding, availability, limitations, and benefits are all totally unlike the US. Government views basic health care is viewed as a social responsibility for the citizens. Emergency medicine, hospital stays, and major medical procedures are also covered. The "No normal human can afford these" life saving drugs are provided as well. For example, the view on HIV is to keep me healthy. That keeps me working, keeps me paying taxes, and keeps me out of the hospital. In the long run, it's cheaper to give me antiretrovirals, than it is to treat me in hospital for Opportunistic Infections. Now with the clear benefits of TasP, it is obvious that treatment prevents more new cases. Universal access to ARVs should be a no brainer for any government. STIs are the same. Treat them at no cost is of benefit, because it prevents onward transmission. It's a Public Health initiative. PrEP is a tough one up here. We're still trying to figure it out. A friend is trying to get on it, but is frustrated by the bureaucracy and the cost (it's not covered). At one point he exclaimed "The cheapest way to get Truvada in Canada, is to become Poz." If the price of PrEP was reasonable, then expecting someone who wanted it to pay for it would be doable. But it is ridiculously priced. We need a Dallas Buyer's Club for PrEP. Mass purchases, at a discount then pass the savings on to the consumer. Maybe once it goes generic, it will get more widely adopted. With the current prices, I expect some push back from US insurers, if there is a big uptake. I'd be willing to bet higher co-pays will appear I think a guy who takes PrEP is taking personal responsibility, and an interest in his health. A Poz guy on meds i the same thing -- being responsible. Both are socially responsible as well -- preventing the spread of HIV. I often wonder if the "me first" - "you did it to yourself, why should I pay for it" attitude of the far right, stems from the puritanical roots of the USA. The same could be said for views about sex. They love to use guilt and shame as tools of oppression. And in your letter I see you feeling both of those. I'm truly glad they're pushing PrEP hard in Atlanta. Hopefully it will make a dent in new infections.

One thing buried in the New Your Times article is that David Duran, author of the original 2012 "Truvada Whores?" piece, has now changes his mind and is now an advocate for PrEP. In March he posted a piece titled "An Evolved Opinion on Truvada." Too bad his revised opinion hasn't sparked the same amount of attention and discussion as the original.

Here is the full PDF of the Canadian Consensus Statement on HIV and its Transmission in the Context of Criminal Law. Their opinion was based on HPTN 052, the study of mostly heterosexual couples which reported that a person on ARV had a 96% less chance of transmitting the virus, than a person not on treatment. (It's rarely noted that the 4% represents 1 person. The woman caught HIV within ten days either side of her Poz partner starting ARVs. He could not possibly have reached an undetectable viral load in ten days, and she may well have been received the bug before he started treatment. "Mostly straight" means there were 33 Gay couples in that study.) I was sad that the consensus statement wasn't updated with data from the Partner study. But given that this was worked on for a significant period of time before the conference where it was released, and the Partner study interim data was only presented two months previous to the statement's release, their describing the risk as "Negligible" is a pretty strong statement.

I sure hope you mean that guys using meth are much more likely to catch HIV.The way you phrased it sound more like "All Pozzies are Meth Heads." I'd take great offence to a blanket statement like that. We get way too many "All Pozzies (fill in the bad attribute).

The CDC previously said that mathematical modelling using a conservative 2.39 percent HIV incidence suggests that half of all gay men in America who are 22 years old today, will be HIV positive by the time they’re 50. The situation with black men is not confined to the USA. The research done for the Lancet Special Report on MSM & HIV that every place where it was studied, Black MSM have a higher incidence of HIV. It's discussed at about 28 minutes into the Policy Implications of The Lancet MSM & HIV Series.

Assuming you're on treatment and have an undetectable viral load, I think you should print out the interim results from the Partner study. Take it with you. It proves you put him at virtually zero risk. Maybe highlight the 16,400 BB fucks, the "two closer to zero" statements from the researchers, and the expected 86 transmission if the Pozzies hadn't been on treatment. If he's cut print out the "Putting a number on it: The risk from an exposure to HIV" sheet from CATiE, and highlight the 1 in 909. (Don't do it if he's uncut, because the 1 in 161 would probably frighten him.) Tell him that would would have been the risk if you had a high viral load, but (hopefully) you're undetectable. Don't forget to remind him that he had EQUAL responsibility to raise the topic of serostatus, last test date, and how frequently he gets tested. Best of luck. Let us know what happens.

I tried to talk my Doctor into asking patients if they wanted an HIV test annually. Basically TasP, just like they're doing in BC. He was firmly rooted in the "Risk Assessment" model. He would only recommend it for people he considered at risk. Every point I raised he countered with something lame. CDC recommends it. BC's finding 7 per 100,000 that didn't know they were at risk. About 40% of new diagnoses they're finding outside of the normal risk groups are in stage 3 immunosuppression. There are often more Bi guys on the hook-up sites than the gay ones, and I doubt they're telling a doctor that they're Bi. I know I watched a presentation from the most recent TasP confrence, where a commend was made that when they were training GP's, they had to be taught to UnLearn risk assessment. Maybe I should email the BC Centre for Excellence in HIV/AIDS to see if they have any advice. If we can't get governments to officially adopt TasP, maybe we can talk the doctors into it, if we can provide compelling enough arguments. We know there's a large pool of untested, and untreated guys out there, and they are the ones driving the pandemic.