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Well, there have been gays since the beginning of time. Were they all waiting to be "completely gay" until 1981 when AIDS appeared? Will they stop being gay 10 or 20 or 50 years from now, after there's a cure?

Caution is always smart, but we have a tendency to fear disaster when it comes to sex that is out of proportion to the facts. Evolving diseases are a fact of life on this planet. Most of them are not sexually transmitted. Other than our moralistic programming, there's no more reason to fear sex than eating, drinking or breathing. This season the flu is killing 4,000 Americans EVERY WEEK. Gonorrhea? Killing nobody.

Resistant strains are a real concern but the media tend to sensationalize stories about "superbugs." The number of resistant cases is still small and so far they have all been treatable, though it can be more difficult to do so. Oral sex has been a factor in cases of resistant gonorrhea. The infection can hide in the throat without symptoms. It's very important when you get get tested to get not just a urine test (which only detects infections in your dick) but also throat and rectal swabs. Also: gargling with Listerine (for at least a minute) reduces your risk of oral gono. https://emen8.com.au/sex-and-dating/sex/antibiotic-resistant-super-gonorrhea-how-worried-should-we-be-here-are-the-facts/ https://www.huffingtonpost.com/entry/gonorrhea-treatment-listerine_us_5857fb4de4b0390447097f64

Another thing: Truvada as PrEP has been shown to reduce the risk of getting genital herpes by about 30%. I honestly can't see any reason not to go on PrEP because you're scared of STIs. All it does is take HIV off the table, and gets you tested regularly for the others. It doesn't dissolve condoms if you still want to use them. https://www.hivplusmag.com/prevention/2014/07/02/study-truvada-prep-shown-lower-herpes-infection-rates

The official guidelines (and, usually, insurance coverage) are to give the HPV vaccine before age 26, before a young person is likely to have been exposed (they don't know the young sluts I do, haha). BUT even if you're older, it can still give protection against strains you have not yet been exposed to. Many doctors who treat gay patients recommend it. I had it, even though I had to pay out of pocket. I think anyone on this forum should seriously consider it.

There's really no point to all this speculation, @concerned1. You're only going to make yourself sick with worry. Just go get tested. It might be scary, but it is far better to know the truth. If you're negative, you can consider going on PrEP. And if you're positive (which is possible but relatively unlikely if you've been exclusively top), you have the option of going on treatment immediately. That will minimize any long-term damage to your health, and will mean 0% chance of infecting your future partners. Either way it's a win-win.

Depression is not a frequent reported side effect. I've been treated (successfully) for depression for years and Truvada had no effect on that. Of course your mileage may vary, but don't rule it out because of those fears. A minority of people get the intense dreams fur a few days. Most say they're great and are sorry when they stop. I didn't get them -- wish I did!

A good forum to ask these questions is the PrEP Facts Facebook group. It has 20,000 members so someone is likely to have experienced whatever it is you have questions about. (It's a closed group -- your other Facebook friends won't see.) www.facebook.com/groups/PrEPFacts

Doxycycline does NOT clear up gonorrhea. You may have read outdated information. The only effective treatment today involves both a shot (ceftriaxobe) and pills (azithromycin). Gonorrhea is a wiley bug.The experts are worried that it may evolve to be resistant even to the last treatment. At this point only a very few cases are fully resistant -- and they're still treatable, it's just much more difficult. No one is dying of gonorrhea. But it is a big concern. The reason why STDs have so quickly become resistant is because antibiotics are being used incorrectly, including by people ordering them online because they are afraid to seek professional treatment. Please do not contribute further to this trend. It is dangerous for all of us. There is no shame in contracting an STD. Go get it taken care of. If your doctor gives you grief about it, find a different doctor. See: https://www.cdc.gov/std/gonorrhea/treatment.htm (how gonorrhea is treated) https://www.cdc.gov/std/life-stages-populations/stdfact-msm.htm (STD factsheet for men who have sex with men).

Just because you're not afraid of HIV doesn't mean you need to become poz. I lost my fear as well... all that means is that I can enjoy sex to the fullest without paralyzing fear. I don't expect to get HIV (being on PrEP) but if I did I would be fine, though there are definite disadvantages to being poz. I did the chasing thing and it was a thrill for awhile, but like any new thrill it wears off and you want to move on to something new. Fortunately I didn't get a lifelong souvenir of that phase of my life.

The idea of a poz "brotherhood" sounds really hot but let's think about why that brotherhood developed. Just like with many other stigmatized minorities, poz men initially bonded over common experiences and hardships, and found comfort in solidarity. It's a great thing that they have that support, but it doesn't mean it's something to aspire to for its own sake. Life is harder being poz -- no way around that. I've known people in the deaf community and it is a tight-knit and supportive one, but I'm not going to deliberately destroy my hearing in order to join it. At present it seems like fun and games -- you can get pozzed and have the option to go on meds before you get sick -- it doesn't seem like a big deal. But we're taking a lot for granted. Treating one HIV+ person costs tens of thousands of dollars a year. (Even if you decide to let yourself die "naturally" it's a costly matter.) The US government currently guarantees HIV treatment through the Ryan White Care Act -- but that is precarious in the current political environment. If the economy goes to shit, things could get ugly. Look at Venezuela, where the collapse of the economy means people who have been healthy undetectable for years are now dying of AIDS. I've been both on and off PrEP, and I understand the powerful erotic pull of men sharing the virus as a way of bonding. But being on PrEP I feel I can bond just as much with both neg and poz guys. Instead of trying to pick a tribe, let's create a big tent where we can welcome both poz guys and PrEPsters into the brotherhood of unbridled pigs. And, in the process, save ourselves and society a lot of unnecessary expense.

The thrill of chasing will last until you are poz, then it's over. It's like the dog chasing a car -- what does he do if he catches it? I know that urge personally and I've had phases of chasing. I quit PrEP for a year because I wanted to feel the incredible rush of risk... but I recently decided to restart it because I'm thinking longer term then just my current sex life. If you quit PrEP you might get lucky and ride the chase for a long time... or you might get infected in a week and then the game is over. You're still gonna have to take pills the rest of your life if you're poz, so why not just take them now as PrEP?

That is bullshit, scott0882. Find a new doctor who isn't a moralizing asshole. Check out preplocator.org

That's a good point. It sounds from the dates of your posts like you were only on PrEP for two or possibly three months. You may not have given it enough time to really just forget about it. Like LKMike, when I'm on PrEP I just take it with my vitamins (I use one of those weekly pill sorters so I don't see the Truvada bottle) and I barely think about it. Think about PrEP like a time machine: either back to the 1970s before AIDS... or into the future (10? 20? 50 years?) after there's a cure. HIV is a tiny slice of the history of gay life, comparatively speaking. Didn't guys enjoy sex just fine before HIV, and won't they after it? The existence of HIV is a small blip in history and it's nonsensical to think that it always has been and always will be central to being gay. Don't get too caught up in the idea of pozzing as inevitable just because it is a fad in 2017.

To clarify: I did not poz my buddies... I was and remain negative. Most of them have at least some idea how they got infected. I didn't pry, but was a good listener and supportive friend if they volunteered those details... and then masturbated furiously thinking about them alone later.

Just catching up on this amazing thread and your previous one. Much food for thought -- pardon the length of my reply. I can relate to your story, as a chaser who went on PrEP and then off it. I'm also brainy and educated and have a reputation for being cool-headed and rational. I do think the risky sex I crave is an important counterbalance to my persona (just as some sub bottoms I've met have been powerful, in-control men in their professional lives). I'm of a generation where HIV was genuinely terrifying. The fear was in fact sometimes immobilizing: I'd have heart-racing risky sex but then live in terror for weeks until I could get the next test results. Like many others, my initial attraction to seeking out intentional infection was not a wish to be HIV+ as such, but a need to get that fear out of the way. Poz guys were indeed magnetically attractive to me -- in part because they were already freed of that fear. They had faced "the worst" and it wasn't so bad. Most had been infected by accident (and often it was traumatic in the short term) but it did seem to have a liberating effect sexually. Some, however, made a more deliberate decision to leave the fear behind, have the sex they wanted, and accept the probably inevitable consequence of HIV. A few went a step further, wanting to take control of their seroconversion and to choose the man who would infect them. These guys in particular seemed especially ballsy and attractive to me. I think this cohort, which grew out of necessity in the pre-PrEP world, planted the seed (no pun intended) of today's chaser culture. The particular circumstances that created the subculture were a moment in history that is passing. It will be interesting to see what becomes of bugchasing in the new era, especially if/when a cure for HIV is developed. (I've read that when tuberculosis was incurable, around the late 19th century, there was a certain romanticizing/eroticizing of it... the subject of the opera "La Bohème," which got adapted into "Rent" in the 1990s, with the disease updated to AIDS... but I digress). I was at the point of accepting the inevitability of seroconverting and had fantasies of choosing the time and poz top to make it happen, but as you will have seen on this board, that is easier said than done. In any case I was letting go of the fear and openly seeking out poz partners. Then PrEP came along... and suddenly there was another option. I hesitated a bit because of the issue of taking meds with potential long-term consequences, but that is really a bullshit consideration because (a) PrEP is really very well researched and overseen (b) the current PrEP drug, Truvada, will almost certainly be superceded by other options with even fewer side effects soon enough -- no one is going to be on today's form of PrEP for years and years, and (c) once poz, you will be taking the same meds as PrEP, and more, for life, with no option to quit (unless you decide to let the disease run its course, something that really doesn't appeal to me -- it's an ugly way to die, though I recognize there are a select few for whom it is a turn-on), Anyway, I started PrEP about 4 years ago and went on to enjoy a freer and more unbridled sex life than ever before. I did it all -- clubs, bathhouses, Cumunion, and lots of hookups, intentionally seeking out poz guys (who seem on average just better in bed than negs, by my non-scientific observation!) It was mostly pure joy. (I have gotten STDs with some regularity, however, and though it's the price you pay for a liberated seed life, it can be a major annoyance and expense.) That said: on PrEP I missed the thrill of sex that had the possibility of a real consequence. I do relate to chasers who use pregnancy metaphors: infecting another man with HIV is the closest analogy we have to the chance a straight man has of impregnating a woman. The mystical element of converting another person turns me on intensely... though it's pretty twisted when you think of it -- impregnating someone creates life while converting someone, in the absence of meds... A major event was when I reconnected with an unmedicated poz guy I had chatted with several years ago, when he had tried to sweet-talk me into letting him poz me. We had never actually met, but I was planning to be in his city in a few months. So I made a "New Year's Resolution" to quit PrEP and did so, in early 2017. Just like for you, the thrill came back. I had some intense experiences, not least of which was finally meeting the "gifter" and taking his load -- in some sex that was very quick, brutal, and among the hottest of my life. It was an intense few weeks of waiting but the gift didn't "take." No huge surprise really... as everyone on this board knows, there are no guarantees and the odds of any single fuck knocking you up are relatively small. Still, it was a fucking THRILL. BUT... and there's always a but... thrills can't continue indefinitely at the same level of intensity. The outrageous becomes normal, and then you either adjust to less intensity or you have to seek out new extremes. Over the past 11 months I've had some great episodes (and will jerk off to the memories forever) but I've also continued to think about the tradeoffs. During this year I've had four close buddies seroconvert. None of them wanted it -- in fact they were all considering PrEP in one way or another but hadn't gotten around to it. They've adjusted and it hasn't been the end of their lives, but I've seen the shit they've gone through with insurance issues, worries about changing jobs or moving countries, side effects, fatigue, and not least of all a LOT of stigma that has really been a bummer for their sex lives. It has not been a picnic. Without exception they would go back to being neg in a heartbeat if they could. (None of them knew I had quit PrEP and I must admit that having sex with them once they were poz was so hot for me... though they were all undetectable by the time we did it, and I would never admit my chasing fantasies, which I think would have shocked and hurt them deeply). With those thoughts I began to notice I was bottoming less frequently and topping more (I'm naturally pretty vers though obviously when in chasing mode it's bottoming that's the real thrill), I think unconsciously moving away from risk taking. I also read the account of a chaser who, once he converted, no longer got much pleasure out of sex at all. If the thrill is in the risk, and *either* being on PrEP *or* being poz means there is no risk, then I think the effect will be the same -- with the obvious difference being that once poz there's no going back. (To answer your question above: would having sex with poz guys still be as thrilling once you're poz yourself? I don't think so, though sex with any liberated, self-assured guy will always be hot). I think you see that in a lot of the chat on here about poz guys seeking out other strains, hoping for "superinfection," even eroticizing other infections like Hepatitis C. They've used up that one fetish so they are pushing the envelope ever further in search of a new thrill. I must admit that the idea of pozzing other willing chasers myself has been a powerful turnon. But in itself I'm not sure it's enough of a reason to overlook the other drawbacks I've mentioned. And I also know myself well enough to know that if I pozzed someone, even at his request, and he later ended up regretting it, I would have a hard time living with that. So, long-winded way of saying that I've decided to end the yearlong "PrEP holiday" for now. I seem to have made it through still negative, and I had a great ride for a few months, but there is more to life than chasing thrills. This isn't necessarily the end of the story -- the option remains to go for another spin of the roulette wheel. But a major difference is that I'm twice your age and the opportunity cost of doing so would be commensurately smaller. Your sexual drives and tastes evolve a great deal between 20 and 40. Your brain's capacity for judgement isn't even fully formed until your mid-20s. Don't assume that what turns you on now, and how you feel about making irreversible decisions, will always be the same. If you can make your peace with the slightly less heart-thumping reality of PrEP sex, it will keep more options open for you in the future. You can always change your mind again later.

@LittlePrEP Your partner definitely deserves to be part of this conversation. It could be a real blow to him if he found out you had deliberately gotten poz by his seed without his knowledge. It's not worth risking hurting him. Hopefully he will understand your need and your desire for this bond with him -- but if he doesn't, it could destroy him, and your relationship. Talk to him.

Thank you for your honesty, 1happyhomo. I sincerely hope your husband will beat this and you will continue to have many happy years together. It's noble that you wish you could share in his suffering, but how would that really help him? He needs you, more than ever, to be healthy and strong for him now. We all lose people we love, throughout our lives, and we don't react to it by trying to throw ourselves off the same precipice. If we did, humanity would snuff itself out. I can't tell you what to do, but I know what I would do in your situation: take meds, to be sure I'm there for my beloved when he needs me most. I understand the erotic pull that death has on some of us. The French call an orgasm "la petite mort" -- literally, the little death. But I'd rather put death off as long as possible, so I can continue to explore the endless possibilities for sexual adventure, intimacy, and connection that a long and healthy life can afford. The fact that we have the option of sharing the bond of the virus without necessarily committing to an early demise is, I think, a beautiful thing. It's up to everyone to decide for themselves, of course, but I'd like to think I'll still be busy initiating young queers into the Brotherhood when I'm 70 and beyond. (Hopefully they'll continue to refine and improve Viagra!)

In the US, the "sticker price" for PrEP is astronomically high -- like $1200/month. But almost no one pays that. Many insurance policies cover it, and the manufacturer (however evil they might be) provides it free to uninsured people below a certain income. It's possible to get PrEP affordably, it just takes some research. As for generics, the US FDA (drug regulatory agency) just approved a generic version of Truvada. It will still take several more steps for it to come to market at an affordable price, but things are slowly heading in that direction. In the meantime, you can order PrEP online from reputable generic makers in non-Western countries, like India. It has been tested and found to be safe and genuine by users' groups in the West. See, for example, iwantprepnow.co.uk

I apologize -- I should not have made a comment about your English. Otherwise, I stand by my position. "...every drug has negatives which is why some you have to be monitored carefully this is one of those drugs becuase it has serious side effects." Aspirin has serious side effects, too. We take advantage of its benefits and weigh the potential side effects in the balance. Truvada for PrEP is no different -- and indeed no more dangerous than aspirin. http://www.hivplusmag.com/prevention/2016/1/06/new-study-shows-prep-safe-aspirin "Using the excuse now about long term it's cheaper to give people prep rather then treat hiv is poor excuse people should be responsable..." People should be responsible -- yes. But, after 35 years of telling people to use condoms, they are still getting HIV by the millions. Do we just let them get infected because they weren't "responsible"? If someone recognizes he is not able to maintain perfect condom compliance and is at risk of contracting HIV, using PrEP is a responsible choice. "To throw around stats without peoples medical history show's that you have no understanding of the field as I stated before peoples health state can have effect on how a drug will work..." Of course an individual's medical history and health state play a role, and a prescriber will take these into account when deciding if PrEP is appropriate for that individual. But the statistics about safety and efficacy are aggregate and take into account test subjects with many different backgrounds and conditions. "...most problems with condoms is people not using them correctly." Exactly. And this despite 35+ years of attempts to teach people how to use condoms . Condoms work well for some individuals who are able to use them correctly and consistently. They should by all means continue to do so. But as a public health measure to end the epidemic, they have plainly failed. You can continue to repeat the same thing -- shouting ever louder about condoms -- and expect a different result. Or you can take advantage of the new tools at our disposal.

I also think if he was really in the medical field he'd be educated enough to know how to form sentences with punctuation, and wouldn't spell agenda "agender."

Yeah, yeah... when it's between an anonymous asshole online referring to "a bunch of friends," versus mountains of published evidence that Truvada is a very safe medication, I'll go with the latter. It really seems like some gay guys (I'm going to assume you are one) have been so brainwashed that gay sex is dirty, unhealthy and bad that they just can't let that go.

This post is so full of shit it's hard to know where to begin. I'll try: "It is true I work in medical field..." Oh really? Fully 1/8 of Americans "work in the medical field" -- from receptionists to brain surgeons. Unless you have specialized credentials in HIV science you really aren't in a position to contradict the experts. "...this drug is fairly new so no one truly knows the long term effect it can have for groups of people." The two component drugs in Truvada have been used for many years to treat HIV+ patients. There are millions of patient-years of experience. The potential negative effects are well known and controlled for. And look, if you get HIV you will face a hell of a lot worse long-term effects, and you'll have no choice but to take even more meds for the rest of your life. For anyone truly at risk of infection, PrEP is a no-brainer. "The last point is you may see the stats which claim protects 99% so on again this is untrue..." Care to provide some evidence for your claim? You are contradicting peer-reviewed scientific research, which states that *when taken daily* efficacy is 99%. The lower effectiveness figures include trial subjects who missed too many doses. "if you want to use this you should have to fund it yourself I do not agree with others picking up the bill..." Rubbish. If people get HIV their treatment over a lifetime will cost FAR more than PrEP -- and others (insurance or national healthcare) will be paying for it. Prevention is a wise investment, which is why most US health insurance companies have made the calculation that it's worth paying for PrEP.

Here's a good primer on how to approach your doctor about PrEP. http://www.advocate.com/31-days-prep/2014/10/16/how-talk-your-doctor-about-prep If he refuses, you might need to change doctors. Here's a source for PrEP-friendly healthcare providers: http://www.preplocator.org

DEFINITELY get Hep A & B shots. Everyone on this site needs them, pronto. Unfortunately there is no vaccine for Hep C. There is a cure, but it's insanely expensive (like $100k). Fortunately it's only rarely transmitted through sex. You can reduce your risk of it by minimizing fecal contact. Stuff like fisting parties are high risk... but it doesn't sound like that's your thing! Another vaccine to consider is HPV -- it can cause warts, cervical, rectal and throat cancer (they're pretty rare, but they suck). The vaccine is normally only recommended for guys (and gals) up to age 26, because they figure by then everyone's been exposed. But some doctors will recommend it for older folks too, because there are multiple strains and the vaccine can protect you against ones you haven't been exposed to yet. Insurance might not pay for the shots if you're older, tho. Finally, ask about a meningitis vaccine. There have been outbreaks among gay men in some big cities. There have only been a few cases but it's awful -- it can kill you dead within hours.