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Been meaning to try the poz-prep party. Ever see any guys with biohazard tatts? That makes me harder than anything.

I took a year-long "Prep holiday" because I missed that thrill of risk that any load could be the one that charged me up. It's like skydiving or riding a rollercoaster... the idea that you could crash and burn is what makes it so hot. I'm not exactly sub (more total vers) and don't think it's my or any gay man's destiny to get pozzed. I made it to the end of the year still neg and went back on Prep. All things considered I'd rather not deal with the hassles of being poz. But it was a great ride while it lasted.

Straw man. You're creating a perfect laboratory animal in Guy #1: someone whose sex life and Truvada use never change for 50 years, who never enters into an exclusive relationship or has a down period sexually, never just plain gets too old to get it up. An unlikely scenario. You're also postulating that, if he simply opted against PrEP, he would remain HIV-negative and hence drug-free. Also a big assumption, given that men who have sex with men have a 1 in 6 chance of contracting HIV in their lifetime (a figure that jumps to 1 in 2 for black men). The idea that it is simply a personal choice between PrEP and not PrEP, and everything else remains equal, is false. Like it or not, condom use continues to trend downward (and it's not because of PrEP advertising, it's because raw sex simply feels better). Opting against PrEP means either resigning yourself to condoms and a smaller pool of willing partners, or accepting the risk of HIV. Lots of guys on this site have chosen, until PrEP came along (and some since) that they'd rather take that risk and enjoy raw sex. If they got infected and never got treated, chances are damn good that they died of AIDS before anything else had a chance to get them. Otherwise, without exception, they went on 3-med regimes. The fact that guys now have the option to go raw with virtually no risk of getting HIV means that they will absolutely end up taking meds for fewer years than Guy #2 over a lifetime (not to mention the fact that PrEP is less drugs than treatment, something you just brush aside). There will likely also be something akin to a herd immunity effect. Already, new HIV infections are dropping precipitously in major cities where PrEP is in wide use, even though uptake is far from 100%. Seroconversions are on track to approach zero in San Francisco. That benefits everyone, and there is no contorted way to argue it is a pharma conspiracy or has downsides for gay men. As for Big Pharma, given the tinfoil hat theory about HIV at the end of your initial post it's not surprising that you are paranoid (and probably not worth my while trying to have ac rational discussion with you about it, but so be it). Yes, they're in it for profit. No, PrEP isn't some deliberate plot to get all gay men on drugs. Gilead (the manufacturer) had nothing to do with the research that developed PrEP -- it was entirely run by academics with US government funds [cue your Alex Jones conspiracy theories about the government]. Sure, Gilead is cashing in -- who wouldn't? But they've barely promoted PrEP, which remains a relatively insignificant part of their sales. As for the fact that no cure has been developed yet: also not a conspiracy. It's just plain hard. HIV is very wily virus. A lot of brilliant minds have been working on this for decades -- and they are not all in on some secret pharma conspiracy to suppress a cure. If Gilead was sitting on one, you can bet they'd be marketing it -- at an exorbitant price, as they do with their Hepatitis C cure. You "do believe most gay men these days are dying from other diseases not even related to HIV." Well, yeah. Because the introduction of ARV cocktails, and now PrEP, has made AIDS deaths very rare. I cannot fathom how you somehow derive from that that those meds are a bad thing.

Here is a comprehensive list of reliable suppliers of generics: https://www.prep.global/get-prep All of these will ship to the US. Many people around the world use generic prep and many samples have been lab tested and found safe. Counterfeit meds are not unheard of but that can happen even with "legitimate" prescription drugs. There are scams out there -- it's an unfortunate reality of life. But it's very rare, and not a reason not to take generic prep if you are at risk of HIV. The only important thing, if you are going to self-source prep online, is to do so ONLY under the ongoing care of a competent doctor/nurse practitioner. You need (a) to be certain that you are HIV-neg on starting and to re-test at regular intervals (b) to have your kidneys checked periodically for potential (rare) adverse effects. I'm pretty sure I've heard of military personnel whose prep is covered by Tricare. You might contact the Prep helpline that helps people work out insurance questions: 1-800-226-2056.

If you are on Prep you are taking Truvada, which contains 2 drugs. If you're being treated for HIV you are taking at least three -- which might or might not include Truvada, but never just Truvada. So it's not the same. There's more potential for side effects or long-term complications for poz guys -- quite apart from the effects of the virus itself. Contrary to what you say, people think and talk about the long-term implications of the meds all the time. Everyone on Prep is closely monitored for potential adverse effects.There are new versions of Prep with fewer side effects coming down the line. One, Descovy, is currently being tested. (Say what you will about the drug companies introducing something new when their patents are about to expire, which is another issue). No one who is HIV-negative is going to be taking Truvada indefinitely. More to the point. Your sex life can change and you can end up no longer in need of prep. But if you are poz, and don't care to die of AIDS, you will have to take the meds for the rest of your life -- even long past the point of no longer being sexual. If you are at risk of HIV and you are not capable of using condoms 100% of the time, it is a no-brainer. Better to take some drugs for some period of time, then to take more drugs forever.

Since you're bi, do you still hope to have relationships with women? You might consider that it will be a lot harder to find women who are comfortable with a poz bi partner than it is to find gay men. I agree with the others: your best bet might be to go on Prep and keep your options open. If you need the thrill of risk, remember that there is still a chance, albeit a very tiny one, of getting pozzed on Prep. It's happened to about three "lucky" guys.

The brain has a strange capacity to turn what we fear into something erotic -- maybe as a way of coping with it. That's the origin of the bugchasing fetish. It's happened with other diseases in the past. Death from tuberculosis was romanticized in the late 19th century -- that's the topic of the opera "La Bohème," reworked in the 1990s as "Rent," with HIV replacing TB. That fad died when the disease became curable, just as this one will. I wouldn't be at all surprised if there were already people, particularly straight couples, eroticizing the fear of conceiving a zika baby. They haven't found each other and formed a "community" yet. As far as we know...

Hey, @btmfreeknc, glad you had fun in Atlanta. I've been a few times and visited some of the same places you did. The only other tip I'd give you if you go back is to go on the fourth Wednesday of the month to the CumUnion party at Manifest. It's the one time of the month there's a decent size crowd there. Quite mixed demographically -- you won't feel out of place as a heavy white dude, but you'll find plenty of hot black guys too. Like any gay sex venue, there's sometimes more wandering around than fucking, but you can have a hot time. Thanks for your honest sharing about trying tina. I'm sure you'll hear lots of opinions, but I found this post really interesting. It's one of many reasons (including knowing friends who got addicted very fast and really fucked up their lives) that I've avoided giving into the temptation to try it.

What ended up happening, @ignignokt? Did you go back on Prep? Did you take those loads first?

You can choose to let sex be "the death of you" FOR YOURSELF. But if you really are, as you seem to think, poz and unmedicated, don't you maybe owe it to all the guys you are topping raw to make that choice for themselves too? Do you inform them that you think you are positive and not on meds? That said, I think you're being overdramatic. You have no evidence that you're poz. There will always be anecdotes of total tops getting pozzed, like the ones we're seeing here, but they remain a small minority. I don't know where you get the idea that the CDC is deliberately underestimating the chances of getting pozzed while topping. Their numbers almost always err on the side of OVERSTATING risk. For example, they insist on stating Prep is 90% effective even though the biggest research trials found it to be 99% effective if taken as directed, and there are only about 4 reported cases of Prep failure worldwide. For your own sake, and the community's, grow a pair and get tested. There's really no downside to knowing. If you're neg (a very likely outcome) you can stop worrying, and you have the option of going on Prep. If you're poz and want to live a long, healthy life, you can start treatment. And if you are poz but really want to let the virus "hoover up your T-cells and eat your brain," you can go for it, with the thrill of knowing it's real, not fantasy. In any of those cases, you will be under MUCH less stress than you are now. Get. Fucking. Tested.

You don't have to become poz if you don't want to. A lot of guys on Prep are the biggest whores and cum dumps out there, and at very little risk of HIV. If I'm reading you correctly, you've never even bottomed with condoms, let alone bareback. Maybe better to take it one step at a time. Sign up for some hookup apps, write a hot profile, take some sexy pics, and say you're a virgin looking to get your cherry popped -- safe only. I'm sure you'll get plenty of responses. After trying that, you may decide you can't stand condoms and want to go bareback. Then you have the option of Prep. There are, of course, guys on this site who choose not to use any protection at all, and deliberately accept the risk of HIV (and other STD's). But that's pretty advanced level, hard core piggery. Most people go through stages before they get to that point, if ever. Ease into your new role as a slut. You don't want to cut short the fun of sexual exploration by getting a rude wakeup call before you're ready for it.

Well it's getting a whole lot of cocks hard!

Great writing! Have you considered publishing anything?

CRF19 is treatable with the same meds as other variants, and as far as we know PrEP protects against it too. The main difference is that it progresses much more quickly to AIDS of left untreated. What remains crucial, whatever variants are out there, is frequent testing.

Your strategy, having raw sex with guys who believe themselves to be negative, is the quickest way to get HIV. Most new infections are passed on by recently infected guys who sincerely believe themselves to be neg, but are in fact the most contagious of all. Get on Prep. There are doctors who aren't self-righteous assholes. Find one of them. Check out preplocator.org

The 85% figure means the reduction in infections in the entire study group -- including those who didn't take the meds properly. If you take the pills daily, the risk is reduced by at least 99%. And HIV is relatively hard to transmit to begin with (a single time bottoming unprotected for a poz top carries a risk of about 1.4%)... when you reduce that by 99% you end up with 0.014%. It's not quite zero, of course... there have been a very few cases (4 or 5?) where someone taking Prep correctly got HIV. And in those cases the guys had very low viral loads and had no trouble becoming undetectable. You run more risk of getting hit by a bus on the way to the sex club. Prep is a really good thing. Take it and don't worry.

What a load of crap. HIV has been disproportionately affecting gay men since day 1 -- it's hardly something new, and it's certainly not due to bugchasing. Bugchasers are a very small community -- and gifters are incredibly rare, as anyone who reads the desperate posts of chasers here knows. This minority fetish plays an utterly insignificant role in the epidemic. The vast majority of new HIV cases are caused by people who are poz but don't know their status. HIV is at its most infectious in the first few weeks, when an antibody test would show up negative. Idiots who identify as "clean," don't get tested often enough, reject anyone who is honest about being poz/undetectable, and bareback with other "clean" guys -- that's who you need to be lecturing (but please don't). Yes, stealthing is unethical. We all know that. And we did even before you popped in with your missionary zeal to inform us. Where else do you stick your nose in uninvited to give sermons? What are you doing to help feed the hungry, house the homeless, and make peace in the world, like Jesus taught? Those kinds of moral messages are far more needed than lecturing others about their sex lives. But somehow busybodies like you are only concerned with what other people do with their private parts. You are clearly motivated by some inner turmoil of your own, not by concern for other people's well-being. Look in the mirror.

You can reduce your risk of oral gonorrhea by a lot if you gargle with Listerine or the equivalent -- deep in your throat, for at least a minute.

Condoms greatly reduce your risk, but sometimes the sores that pass on the infection are on areas that are not covered by condoms. It's worth using condoms if it's your priority to minimize your risk and they don't ruin sex for you!

You CAN develop resistance to Truvada as a poz person, and that's the issue. If you skip too many doses of Prep you can get infected without knowing it. Then if you keep taking the pills you can develop resistance, because Truvada alone is not enough to treat an active HIV infection. So either take it properly and stay neg, or stop taking it entirely and take your chances. This skipping doses shit is not doing you or anyone else a favor.

The official recommendation has been to keep taking it for a month after the last possible exposure, but the more recent thinking is that that's probably too conservative. On Demand Prep only requires you to take one pill a day for 2 days after the last sex. That might be enough, but if you want to play it a little safer, you could do 7 days.

That's my philosophy too. The chances are incredibly small -- like winning the Powerball. But it's fun to buy a ticket and imagine you could be the one!

It's happened something like three times in history... you're more likely to win the Powerball.

That last part is rubbish. You don't need to stop having sex for a week just because you missed a dose. Truvada has a long half-life -- it is very "forgiving" of the occasional missed dose. In the PrEP research trials, no one who took at least 4 pills a week was infected. Of course it's best to aim to take your pill every day, but if you happen to miss one or two, don't stress.

Meds are the safety net NOW... but we're taking a lot for granted. HIV is a wily critter... we have the upper hand now, but there are no guarantees. It costs tens of thousands of dollars a year to treat a single patient. In the US, insurance companies are currently required to cover treatment, and the uninsured are covered under the Ryan White Care Act. But it is a politically precarious time. A worst-case scenario to consider: in Venezuela, people who have been healthy undetectable for years now are dying of AIDS for lack of medication. Think hard about how much you're willing to pay for a hot fantasy. https://www.nbcnews.com/feature/nbc-out/no-hope-left-venezuela-those-hiv-advocates-say-n795866