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I like your enumeration of the three groups, to which I would add injection drug users (IDU). On-demand/"2-1-1" PrEP, handed out in the community and without prescription, would seem to be better for homeless people than daily PrEP. The 2-month injectable is also promising, but it is not compatible with mobility or with a delay in returning for the next injection. Is resistant HIV in people who resume PrEP (rather than starting a complete treatment regimen right away) after having stopped PrEP and become infected unknowingly, as big a concern as people make it out to be? Few drugs are approved to prevent HIV (2 2-drug combination pills with 1 drug in common and the other closely related, and 1 new injectable drug) but many drugs (which can be prescribed in many combinations) are available to treat HIV. In a disaster scenario, wouldn't removing all PrEP agents from use in first-line treatment still leave a big arsenal? I'm curious about current thinking among research physicians. The lack of privacy suffered by young people who remain on their parents' health insurance plans is a terrible barrier to all kinds of important care — mental health, birth control, vaccination, HIV prevention, HIV treatment, etc. (And yet, coverage through age 25 on a parent's plan was one of the first visible ACA provisions. As a privilege for the politically powerful middle class, it could help shield the ACA from repeal. I'm sure this was a careful political calculation.) Here in California young people over a certain age do have a privacy right in medical records, but this does not (and realistically could not) extend to billing records. An explanation of benefits will be generated even if care is provided at no out-of-pocket cost. School- and community-based health clinics that can tap sources of funding other than parental insurance are vital.

@hntnhole, we do seem to have a lot in common. 😉 I appreciate your suggestion to counter a monogamy power-play by telling a partner to his face that I am fucking others. After my divorce, I met an amazing person on BBRTS, and our relationship has been open from Day 1. @ejaculaTe, "control does not imply love" is what I intended. I am embarrassed to admit that I made a poor choice of logic symbol. I should have known better, but my studies are now 25 years in the past. ⇏ is indeed the symbol for "does not imply", but there's a gap between the plain English and the mathematical logic. I should have put, control ⇒ ¬love, which means, "control implies not loving". An easy way to read the (non-negated) "implies" symbol is as "if...then". In this context, I would say, "If you control your partner then you cannot possibly love him". (A dom/sub relationship would, of course, be an exception.) I had thought of just putting, control ≠ love, but power and love are different and can't be compared in the first place, so saying that they are unequal would be meaningless. Only love = love. 😉

I share your political anger, @hntnhole. I wish more people would get angry about these issues, because that's how we start to fix them. I especially like your analogy of the HRC campaign, which helped normalize being gay, in the eyes of the heteros in our lives. I saw a documentary about pioneering GLBT state-level politicians in California, which posited four steps needed to establish rights for any kind of minority group. The first one was simply identifying the people, making them plainly visible to everyone. To me, the HRC campaign and other similar initiatives had that effect. I also like your point about how gay TV characters are now commonplace. Sadly, the treatment of HIV (often simply confused with AIDS) on TV has not caught up with reality. In this domain, TV amplifies misinformation. The only time I've seen PrEP mentioned on a TV show was on Looking. Sure enough, a pair of gay content creators lept right into the trap set for us by heteros and had Patrick stigmatize Brady, who had not only stolen his ex-boyfriend Richie but who dared be open about using PrEP. This petty nonsense validated the false assumption that PrEP users are worthless, dirty sluts — not people who care about themselves and about others enough to do something serious, consistent and effective to interrupt the transmission of HIV. TV and film producers have started to retain consultants when their programs deal with issues like trauma, suicide or sexual assault. Maybe we need to field medical consultants in Hollywood who can explain the difference between HIV and AIDS, how HIV is actually transmitted, that U=U, and that PrEP is available. One measure of success would be to see straight characters taking PrEP. It seems quite logical, because virtually all straight sex is condom-free (and this is not stigmatized). I've had more than one straight male friend get curious when I mention that a pill can prevent HIV infection. (And of course it works for women and trans people, too.) Political changes aside, what do you think about medical changes, namely, relaxing the requirements for prescriptions and testing, only for populations who would otherwise never use PrEP?

@Lily95, you should never feel the need to go into your personal circumstances online. Here are some general tips that might be relevant, based on what you have written. They are purely for your consideration, not for a response. Some you may know, and some not. Some may apply, and some not. Oregon is indeed a Medicaid expansion state, which means someone earning up to 133% of the federal poverty rate is eligible for Medicaid. For a 1-person household, this is a little over $17,000. If your annual income is less but you were rejected for Medicaid, please go to a city or county health department or find a local non-profit health clinic. They will assign you a caseworker who can help you to apply successfully. Above that income level, everything is dictated by standard Affordable Care Act subsidy rules. If you applied for private insurance directly from an insurer, you were not offered a subsidy, because plans sold directly by insurers — though identical to plans sold through an ACA marketplace — are incompatible with ACA premium subsidies. Also, even if you did apply through an ACA marketplace, but in 2020 or before, subsidies have been substantially increased for 2021 and 2022. Please check the appropriate state or federal ACA marketplace (I don't know whether Oregon is one of the states with its own marketplace, or whether it simply sends people to the federal marketplace.) Many local government agencies and non-profits can assist you with an ACA health plan application. They receive special money to provide this help. Getting health insurance requires research, paperwork, and patience, but it is worth the effort. Everyone deserves health insurance. You are worth it!

Tell us more about that, if you would like to share. Hot BZ profile pics, by the way!

Love the Peter Pan description! Seems just like goods at the supermarket, always priced at 99¢ instead of $1, possibly with quality to match. What do people expect for 99¢? 😂

Admittedly, and it is very important to talk about the situation in 2022 to dispel persistent myths that PrEP is unaffordable. It makes me angry that you had to go through a period of uncertainty about your PrEP coverage. PrEP's inclusion in the preventive care mandate dates back to June, 2019. Even today, some private insurers surely try to shirk their legal responsibilities, so patients have to be vigilant. Your state's insurance regulator is the place to start when there are problems. Patients shouldn't have to be advocates, but as you say, insurance plans can be "opaque". Unless your old plan was Medicaid (low-income earners), Medicare (seniors) or VA (veterans), you would have been eligible to have Gilead pay all or most of your $5,000 out of pocket Truvada renewal cost, at least one time that year, with a simple phone call and no income ceiling. Today, Gilead's Advancing Access patient assistance program pays up to $7,200 per year, an amount that has risen over time and that was switched long ago from periodic to lump-sum, to accommodate people whose insurance plans have annual deductibles. (Again, deductibles are no longer a concern for most, due to PrEP's inclusion in the preventive care mandate. The rare person with a grandfathered plan who wants to use Gilead's patient assistance program now that generic Truvada equivalents have been approved, has to have a Truvada prescription written so that generic substitution is not allowed, or to be on Descovy, for which no generic exists.) I agree completely. That said, the ACA was a significant legislative achievement. It has also proven, in its phases of implementation, to be a big practical improvement. This is true down even to the details, like the regulatory requirement that when your insurer gives you a list of doctors who are in your plan, the list must be accurate and the doctors listed must be ones who are accepting new patients. Before the ACA, those lists contained nonsense. The ACA is also a legislative achievement that can never be repeated, as gerrymandering and the elimination of voter protections make future Democratic victories numerically untenable. This is certainly possible, but it's more likely to occur through judicial action (the same religious nuts who think birth control is murder are litigating the preventive care mandate; apparently, all forms of preventive care are also unchristian). If and when Democrats lose all three of: the presidency, the Senate majority, and the House majority, then it could also happen through legislative action. At that point, my advice to people who care about their health would be to move to states with strong state-level health insurance regulations and adequate safety net programs, California being an example. Again, it shouldn't be that way, but health care (in general) has such a big impact on our lives that it is worth factoring it in to our decisions about where to live. I tried to cover even the worst case in my post. If we do lose the preventive care mandate, or the Affordable Care Act itself, Aurobindo's generic Truvada at about $1 per pill, combined with intermittent or "2-1-1" PrEP in the 2021 CDC guidelines, would allow many people to continue their PrEP care. But for now, let us have no part in perpetuating a belief that PrEP is expensive and inaccessible.

A thread in another forum, veered off into discussion of why people facing the greatest risk sometimes stop PrEP. I'm starting a new thread here to continue the conversation. Please add your own observations, @hntnhole, @WiChaser, @MrsTatt00, and others. In surveys, common reasons that young MSM in San Francisco give for stopping PrEP are: • Losing health insurance • Believing that their sexual risk has dropped Correlates that researchers observe are: • Precarious housing • Precarious employment It's hard to be certain, because people may be embarrassed to admit that they have stopped PrEP, and may tell counselors what they think the counselors want to hear. Negative signals are often more informative than positive ones, but harder to get. For example, a few years after she had started her small business, I told the owner of my local bakery that she should routinely overbake, count what's left at the end of the day, and cheerfully throw it out. The value would be in the data. Even if she could survey all of her late-afternoon customers, she could never know for sure what they would have bought if it had been on the shelf, in front of them. Insurance changes: Despite Medicaid expansion, generous Affordable Care Act subsidies, and the preventive care mandate, any change in insurance can interrupt PrEP access for months. Without a universal health insurance plan, I don't know how to solve this. For now, the focus ought to be on cheap, convenient bridging, such as giving clinics money to dispense 30-day bottles of Aurobindo's low-cost generic Truvada on the spot. Reduced risk: Often imaginary, this gets at the sense of invincibility that @hntnhole mentioned. Maybe logging pills taken each day, and sexual activity, and seeing a current risk score would help; some PrEP studies provide apps for this purpose. If sex tracking were integrated into hookup apps like Grindr, people might be more likely to try it. Intermittent or "2-1-1" PrEP seems to be a vital alternative when people believe they no longer need daily PrEP. Precarious housing: So many health care processes require a fixed address. ACA applications, public benefit recertifications, insurance ID cards, drug rebate coupons (where still necessary), and other bureaucratic nonsense should be reduced to the bare minimum and be made available from mobile Web browsers on cell phones. People who don't want to mail documents, and who can't receive documents in the mail, shouldn't be excluded. Patients should always have the option to pick up PrEP prescriptions near where they are at the moment. Precarious employment: It's time to decouple all health insurance from employment. It's also time for stupid, backward public and private medical offices to offer evening and weekend drop-in hours. If we want to protect vulnerable people, staffing up is worth the cost. To be really blunt, people with economic resources, political influence, and good health care enjoy fucking vulnerable people. What comfortable middle-class bottom doesn't like taking dick from an edgy thuggish badboy top now and then? (I'm deliberately speaking in stereotypes.) Investing in protecting vulnerable people protects everyone. The fewer barriers, the more people will use PrEP and the more HIV infections will be prevented. I'd like to see small quantities of Truvada/generics, with easy-to-follow "2-1-1" instructions, handed out without prescription at sex clubs, glory hole places, cruising areas, and gay events/parties. I'm always the first to say that PrEP should be used under medical supervision, but open access might be the only way to reach high-risk people who don't engage with the medical system. (Paradoxically, the problem is worse and more insidious in jurisdictions with universal health insurance. For example, for the first few months of the COVID-19 vaccination campaign in Ontario, Canada, there was no way for undocumented immigrants, immigrants with legal status but still in their first three months of residence, visitors from other Canadian provinces, and homeless people who had lost their health cards, to get vaccinated. No Ontario health card, no vaccine, and fuck you! Every health system needs flexibility.) Maybe throw a home HIV test in the package, knowing that it's a lousy, second-generation diagnostic that can only tell you your HIV status as of 3–6 months ago. It's cheap, easy, private, and better than nothing! Of note, the 2021 CDC PrEP guidelines have relaxed safety monitoring. For people under 50 with good initial kidney test results, kidney monitoring is now yearly. Throw in a coupon to visit an outpatient lab (or a chain pharmacy?) for a kidney test, and hope some people use it, but don't let safety monitoring be a blocker! HIV treatment regimens carry a far greater risk of side effects than do HIV prevention regimens.

What does he expect to happen? When I told my ex-husband that I'd been fucking, getting blown by, and blowing other guys for years, I had to explain the obvious to him: you refuse to open things up, you stop putting out often, and then what do you expect? I always kept my cheating in perspective. Whereas I restricted my activities to the physical (no love, few regulars) my ex had fallen head-over-heels in love with a guy online. 🙄 Talk about a double standard! Incidentally, seeing a man I love get fucked by others is a huge turn on for me, as is knowing that he's "cheating". (The quotes are there because I reject the whole concept. I don't believe I have the right to limit another person's sexual activity. This is doubly true if I claim to to love the person. Control ⇏ love.) I had tried many times to line up guys to fuck my ex while I was away traveling, but he'd just meet them platonically. So dull! I fucked several of his friends before he did. To make a long story short, I would have been overjoyed to "share" him with his new love interest, but he once again wasn't interested in an open relationship. Here's hoping that you will soon have some fun on the side, @Dcbbslut123. Please keep us posted!

For other Americans who come across this thread and who are interested in PrEP, it is now free in almost all cases. • Virtually all private health insurance plans are required to provide all PrEP care, that is, office visits, laboratory tests, and an FDA-approved PrEP medication (of which there are now three: two pills and one injectable) free of charge, that is, without applying a deductible and without charging flat-dollar copayments or percentage coinsurance. Plans cannot require any form of pre-approval for the free PrEP product that they cover. This is the preventive care mandate. Grandfathered plans are the only exceptions. • In all states, people with moderate incomes qualify for Affordable Care Act private health plans, all of which are subject to the requirement mentioned above. Generous subsidies are available, based on your income and the cost of the plan, to reduce your monthly insurance premium. • Medicaid plans in many, if not all, states also cover PrEP care at no cost. In states with Medicaid expansion, it is easy for people with a low income or no income to qualify for free health insurance. • In some states, Ryan White Act funds are available to cover PrEP care. • Gilead, the original manufacturer of two of the three FDA-approved PrEP medications, offers two patient assistance programs. Regardless of income, people not participating in government insurance (Medicare, Medicaid, VA) can receive thousands of dollars a year toward the cost of brand-name Truvada or Descovy. A quick phone call to Gilead's partner is all it takes. People with low incomes can apply to have Gilead pay the full cost of either medication. Your health provider must then write your Truvada prescription so that pharmacies cannot substitute a generic equivalent. (Generic drug manufacturer Teva has a less generous assistance program and prices its product at nearly the same price as Truvada. Generic manufacturer Aurobindo has no assistance program, but prices its product at a much lower price than Truvada; see below.) There is no generic equivalent of Descovy, so substitution is not a concern. Patient assistance programs do not cover office visits or testing. That said, there are very few scenarios where a person would need a patient assistance program anymore, given the options mentioned above. • Aurobindo makes an approved generic equivalent to Truvada which sells for about $1 per pill. Especially when used with on-demand or "2-1-1" PrEP, per the 2021 CDC guidelines, this drastically reduces the cost of medication. Obviously, office visits and lab tests are not included. Once again, today, most Americans are able to obtain free public or subsidized private health insurance if they have no, low, or moderate incomes. • Rules of practice in some states allow non-doctors to prescribe PrEP. Depending on the state, a nurse practitioner, a physician's assistant, or even a pharmacist can prescribe PrEP. This can drastically reduce the cost of office visits, again, in the rare cases where free or subsidized insurance is not possible. Do not assume that you cannot afford PrEP. Visit a federally qualified health clinic in your area, a GLBT-focused health clinic, a branch of Planned Parenthood, a city or county health department, or a non-profit organization that assists with Affordable Care Act enrollment. As a last resort, look up "Advancing Access" from Gilead, or ask any pharmacist about Aurobindo's generic version of Truvada. Also: If PrEP were truly unaffordable to you, then HIV treatment would also be. HIV treatment requires more visits, tests and drugs (typically, a daily pill with 3 drugs, instead of a daily or intermittent pill with 2 drugs, for PrEP). Please, ask one of the agencies listed above for help. If you don't seek help to for PrEP, you might end up having to seek help for HIV treatment.

I could understand reluctance to disclose HIV-positive status in a Grindr profile — or HIV-negative on PrEP, which also invites stigma. Date last tested does not reveal any medical information, though. Grindr doesn't specify what test(s) a person should get to fill out that field. Quantitative viral load, for someone who is Poz? For someone [who thinks they are] negative, second-generation antibody (accurate as of a few months ago), fourth-generation antibody + P24 antigen (accurate as of a few weeks ago), or qualitative viral load (accurate as of a few days ago)? STI, regardless of HIV status? Which STI(s)? Must the STI test result(s) be negative, or does completing treatment count too? I cannot tell anything about the tests people got, let alone the results. All other factors being equal, I can tell that Grindr users who openly disclose a recent test date care more about their sexual health and mine than those who leave the field blank or put a date months or years in the past. (For fuck's sake, we're on a gay sex app; we not only meet the CDC's definition of, but we also epitomize, high risk! I celebrate that classification because it's realistic and it means we like to fuck.) The less profile data, the more likely I am to block. I'm on Grindr because I'm ostensibly a skilled top, decidedly not because I'm a skilled detective. Sorry, but my crystal ball is broken. A nuisance chat this afternoon served as a good lesson to me. A guy with pictures but a thinly filled-out profile messaged me, suggesting that I come over. I was out shopping. I show my distance, explicitly name my home city, and mention that I take transit. Any other Grindr user immediately knows whether we're both in my home city at the moment and if not, whether we're close enough that I could come over right now. I re-checked the guy's profile. Distance hidden. Text empty. I gave him the benefit of the doubt, replying that I was open to meeting but that I was on foot and had no idea where he was. I added a plain smiley face to avoid any hint of frustration. He answered that he was in Berkeley. The city narrowed it down to 10 square miles. Like a famished, fast-running animal on the savannah, zeroing in on a delectable piece of prey, I experienced an adrenaline rush. My dick hardened. Any closer and I would have started leaking precum like a faucet. In all seriousness, how the fuck should I know whether I could get to his place? If he was afraid of sharing his location, then cross streets, a landmark, or a neighborhood would have helped. With 4 billion men on the planet, of whom 200 million are fags, 100 were nearby on my Grindr grid at that moment, and 75 were bottom or versatile, I blocked this one instead of asking again, how far away? In my experience, Grindr users who are eager to fuck share information readily and reciprocally. - - - This isn't directed at you specifically, @Shotsfired. I agree with you that Grindr made a mistake selling profile data with HIV status. Some straight "analytics" expert must have assumed that all profile fields carry the same low significance. Little harm was done because Grindr users need not identify themselves. Apple iOS provides an anonymous numeric user ID when the app is installed. A user can give whatever e-mail address they like when creating the Grindr account; let us hope that people know not to use an address that identifies them by name. No pic is required. The sad reality is that, for anyone who has done a Web search about HIV testing, followed within weeks by a Web search about HIV medications from the same IP address or from the same device (distinguished thanks to JavaScript code embedded in most commercial Web pages; the code assigns a unique "fingerprint" by querying for and combining parameters such as exact Web browser version or "user agent" string, screen size, memory capacity, and operating system version), Google could easily use its "big data" processing capabilities to infer positive HIV status. Google owns identifying information for all Android users, and for any iOS users who log in to Google apps or services. When Google doesn't have direct identifying information, it can generate it by correlation. Google could easily match Grindr profile pics, as well as pics exchanged in private Grindr chats, against its Google Photos database — photos willingly contributed by foolish users — and against its vast index of miscellaneous photos crawled from the Web. It would be easy to match up streams of timed location points from Grindr — which we know to log into with a generic e-mail address — and from a weather app — which we are more likely to trust and to log into with our regular e-mail address. Presto! Google could infer that a specific person was HIV-positive and sell the information as part of the person's consumer profile. More properly, Google would be selling the information indirectly, by using it to target the person with HIV-related, paid advertising.

Tell me more. As a top I love signals! Am I the only one who looks for the contour of the elastic border of the leg openings of briefs or boxer briefs when a guy is wearing form-fitting pants or shorts? (I admit that I get a little bit bored if he appears to be wearing really long, Sears catalogue-style boxer briefs under pants, or if he lets any kind of brief or liner get in the way between a beautiful ass and a pair of tight shorts.)

Just wanted to volunteer my uncut dick for your explorations. 😏 In all seriousness, I appreciate your observation that all the other guys around you were cut. I was one of two uncircumcised boys in my elementary school class. My recent heritage is more than half European, and the other boy's parents were directly from Europe, which may explain why our parents declined the — standard and automatic in those days — procedure. A sex education film shown to us in 5th grade mentioned circumcision. Our teacher commented, "probably all the boys in this class". Thirty-seven years later, I still remember his exact words. Sex ed was at the end of the day, so schoolyard gossip promptly confirmed that our teacher had been wrong. I guess my classmates had noticed while we were changing for swimming lessons, or during our camping trip or outdoor education trips (at least one week away per year starting in 4th grade, sleeping in dormitory bunks). I guess our teacher didn't undress in the same room, or just didn't notice. Schoolyard gossip soon got around to the girls in our class, who repeated the stereotypes that the "normal" boys had shared, of what an uncircumcised penis looked like. This was unfortunate because the girls had surely never seen any penis, cut or uncut, at our age and in those days (a good decade before the World-Wide Web). "Anteater" and "the head looks all funny" are the stereotypes I remember. I wasn't ashamed or hurt by any of this, and I wasn't even upset at our teacher. I had many great teachers, but he stands out as one of the best, because he was rigorous; I became a more serious student under his influence. Academics aside, he was also adept at what we now call social-emotional learning. For that reason, I wish someone in the class had been brave enough to tell him that not all of us were circumcised, so that he wouldn't voice the same assumption in future years, touching off new rounds of schoolyard gossip about which boys in the class were or weren't.

Absolutely agree. PrEP and ART, for all that they are extremely effective, do not eliminate the need for an HIV vaccine or cure. Note: This field of research recognizes different degrees of "cure". If the virus cannot be completely eradicated from the body, can its activity be reduced to the point where no damage is done, but ART can be stopped? Can this low level of viral activity be achieved after a single treatment with the "cure" product? If not, how often is re-treatment necessary? Where to plant the HIV "cure research" goalpost is not a simple or obvious question. There is some noise about PrEP side effects. Truvada, the most common of the three products approved for HIV prevention in the US, was approved for HIV treatment in 2004. Its two component drugs were approved, again for HIV treatment, in 2001 and 2003. Truvada or its components are extremely common in first-line HIV treatment regimens worldwide. Notwithstanding almost two decades of use in a huge patient base, Truvada and its components have also been well studied. There is an ample body of empirical research; the side effects of Truvada are mild or uncommon. Appropriate screening and monitoring for the severe but uncommon side effects of Truvada is part of the US CDC PrEP guidelines. People who are worried about potential side effects should talk with a medical professional who is licensed to provide PrEP care and has specific experience. (Experience is important. In the rare cases where, for example, a PrEP patient has poor kidney test results, doctors experienced with PrEP care know what to do, and can even, in some cases, continue treatment after a pause. I've heard talks by public health and university research physicians in San Francisco on this very point. These people worked on clinical trials of Truvada for PrEP and have provided PrEP care to large numbers of patients.) As for long-term side effects, considering the stakes involved when a person really is a good candidate for PrEP (a high probability that the person would otherwise eventually get HIV due to high-risk behavior), it is irrational to dismiss PrEP solely for fear of side effects that have not manifested in nearly two decades of widespread use of Truvada and its two component drugs. Let us not have any part in sowing fear. An experienced medical professional is the person to talk to if someone has doubts about PrEP.

I don't have direct experience with this, but a close family member of mine has precancerous HPV lesions that require yearly monitoring and, sometimes, painful excision. I would urge you to see a medical professional. Over-the-counter remedies are almost certainly labeled "not for internal use". Please don't take risks with a sensitive part of your body! Let me echo @hairyone's reminder that there is an HPV vaccine. Though it is most effective in young people who have not had prior sexual exposure to HPV, it protects against multiple strains of HPV and can protect adults against strains they have not yet encountered. (Not all strains lead to warts or to cancer.) In the US, the HPV vaccine is now available to adults upon request. Doctors could give it to adults on an "off-label" basis, even before the change in guidance; that's how I received it.

For all that I've made opposite choices about sexual risk, having started Truvada for PrEP within a year of its approval and remained on it ever since, I admire you and your choices, @tranny-trixie. In the early days of the HIV/AIDS pandemic in the US, some young people made the choice to have fun, knowing, in their context, that they would likely die young anyway. I don't want to romanticize anything about HIV, nor about the difficult end-of-life experiences that many of these people suffered, but who am I to weigh the sexual pleasure they enjoyed for many years against the pain they endured for a finite period of time at the end of life? And today, death is not the likely outcome of an HIV infection. In life domains other than sex, I've sometimes chosen to enjoy myself in the short term instead of thinking about the long term. My choices have been unusual, compared with those of my peers. I won't know until I'm on my death bed whether my choices were good ones, but boy, have I enjoyed living so far! You don't need a pep talk from anyone, least of all me, but I think you are frank and courageous, @tranny-trixie

I know from your thoughtful posts that you've considered the things I'm about to mention, but I want to mention them for people who might not be aware. There are some big differences between PrEP for preventing HIV and ART for treating HIV: • You need not continue PrEP the rest of your life, as you must with ART once you have HIV. For example, going through a period of reduced sexual activity, getting into a reliably monogamous relationship, or becoming primary partners with an HIV-positive person whose viral load is reliably undetectable, might reduce your risk enough to warrant stopping PrEP for months or years at a time. (A negative HIV test is crucial before starting or restarting PrEP; always involve your medical professional.) • Whereas an on-demand PrEP option is available, HIV treatment is daily. The possibility of protecting yourself by taking medicine around the time you have sex (to be specific, 2 Truvada pills 24 to 2 hours before sex, then 1 pill every 24 hours until 48 hours after the last encounter), rather than having to take medication every day, is significant. Research confirmed years ago that "2-1-1" Truvada for PrEP is effective, and after official use in France and informal use elsewhere, the regimen appears as an option in the new 2021 US CDC PrEP guidelines. (Intermittent PrEP has not been found to reduce side effects, which are, for Truvada, either mild or uncommon.) • Whereas the vast majority of pill-based HIV treatment regimens involve 3 drugs (whether combined in a single pill or not), pill-based PrEP regimens involve only 2 drugs (in a single pill). This does reduce side effects. The new monthly HIV treatment injection involves 2 drugs whereas the new bi-monthly PrEP injection involves only one drug. This is a dangerous assumption. HIV care can be viewed as a continuum, from diagnosis to treatment to viral suppression. Public health authorities around the world measure the percentages of HIV-positive people who are at each of the three stages. The rate of undiagnosed HIV varies significantly by geographic location, by people's demographic characteristics, and also over time — as does the rate of viral suppression. We see dramatic variations even within single countries. For example, San Francisco has achieved low rates of undiagnosed HIV and high rates of viral suppression, but even here, rates vary with a person's race and socio-economic status. Rural areas, Southern states, states with Medicaid expansion, etc., perform much worse at every stage of the continuum of care. Also, due to the pandemic, HIV testing has fallen off sharply in the US and around the world. Less testing necessarily means more undiagnosed HIV infections. The CCR5 receptor mutation is a research-based concept, but 23 And Me and other consumer genetic testing services are not licensed for any preventive or diagnostic medical purpose, and have not been validated for such use. Only a test licensed for the purpose and ordered by a doctor (in this case, most likely in the context of a university-led research study) could provide an answer that someone could rely upon.

Same here. When he let me enter him bare, and then keep fucking him bare, where did he think I was going to put my load? 😈 In a way, this reflex of trying to pull off at the last minute is like asking silly questions after a bare fuck. Yes, I was tested less than a month ago (says so in my profile), but yes, I've bred and been blown by a few guys since then, and in any case, my DNA is already inside you.

Good come-back for heteros. You can also ask straight men about their mistresses. Amen!

I couldn't agree more! What you've described, incidentally, is San Francisco's City Clinic, which I believe is one of the most medically competent, culturally competent, and accessible sexual health providers in the world. The ideal, of course, is that family doctors, general practitioners, doctors of internal medicine, etc. eventually do the hard work of educating themselves about sexual health care, of making talking about sex a routine part of medical checkups, and of providing stigma-free care. Sexual health is a rapidly evolving field. I could tell you horror stories about general practitioners — typically suburban — who don't have a critical mass of gay patients and who are not humble enough to go back to first principles and read current CDC guidelines when treating an STI or responding to a request for PrEP (or worse yet, for PEP, which is time-critical).

Is it the individuals, or the large number of them, having sex with one another? In my own experience, people who are able to have sex openly are more likely to be informed about sexual health and to think about getting STI tests (still only sporadically, unless they are receiving PrEP care or HIV care). If a given bathhouse attracts lots of people who don't identify as gay, and/or men who are cheating on their wives/husbands/girlfriends/boyfriends, etc., then maybe the number of attendees who arrive with STIs is fundamentally high. On the other hand, let's not discount the possibility that one attendee arrives with an undiagnosed, untreated STI, which spreads, directly, to many of the people that this attendee has sex with, and then spreads, through infectious fluids, to some of the people that they have sex with — an STI superspreader event, if you will. On the positive side, in communities where there is limited access to sexual health care, or to gay-friendly care, bath houses can be a resource, offering drop-in testing certain nights of the week, etc.

Was this the logo that had the single sperm on it?

Disturbingly, Catholic priests do seem to make some exceptions based on age.

All so well said, @Shotsfired! Apart from the problem of guessing the perspective of tags (about the person or about the person sought), how do you feel about the limit on the number of tags? I want to include dom and some fetishes like spit, but have had to focus on essentials like bb, drugfree and vaccinated. On one hand, Grindr's allowing more than 8 tags would increase the potential for affinity matches, and on the other, as happens in BBRTS, where people can check as many preference boxes as they like, too many tags could make it hard to tell what a person likes best. "All emphasis is no emphasis." The lack of engagement apparent in some profiles and in some conversations is pretty sad. (My call for CRM-like functionality could even be misinterpreted as endorsing the takeout menu/store catalogue approach. I meant only that a full and permanent history of our interactions with other people would be useful!) Considering what's at stake — great sex, marginal sex, or no sex; meeting a friend, a fuck-buddy or your future husband, or meeting nobody; feeling energized by interactions or being left lonely — it pays to spend time on what we write in our profiles, on our review of other people's profiles, and on our conversations. "Anything worth doing is worth doing well." Forgive me if I've told this story before. A friend of mine worked as a postal clerk. She explained that a marketing consultant had come in and told the manager to take down all publicly-visible signs with negative messages, prices, etc. Even the wall clock had to go. The consultant was right. In dating apps, we can find the types of people we prefer without putting down others, by using positive statements and tactful triage after people respond. And I don't mean exclusionary statements couched in positive terms, like "Love Asians, white guys and light-skinned Latinos"; the person might as well be listing the groups they don't like. Use of Grindr by non-GLBT people is an unfortunate phenomenon. I'd like to see it made contrary to the terms of use, and enforced with aggressive profile moderation. The "BBC4TS" (to pick one common example) and "no men!" profiles should be deleted, as should profiles of straight women looking for straight men. These are opportunistic invasions of queer spaces, and often involve sex work (which is great, but doesn't belong in a dating app). Although I'm happy that trans people are now welcome on Grindr (they were not always, and their profiles were subject to deletion), I get nervous when I see "T4T" used in a frankly exclusionary way. Last night, I saw "not attracted to facial hair" in a profile. As I waited for the profile picture to load, I was expending a straight guy, but instead, the profile belonged to a trans person. Going on to an app used mainly by gay men and saying you don't like male features is a puzzling choice. In the end, trans people who are only interested in meeting other trans people, and trans people who are eager to meet straight people who are themselves only willing to meet trans people, need separate apps with critical masses of the preferred users. This kind of gay person has been influenced by straight women, who apparently tell the men they meet how many children they want to have. It's a Lifetime movie phenomenon, whereby having children is an end in and of itself, and the partner is incidental.

Unlike BBRTS, Scruff, Growlr and some others, Grindr doesn't have a notion of private profile photos whose lock/unlock status can be toggled for specific people. It does allow you to send arbitrary photos in private chats, and it caches all of the photos you've uploaded for potential use in that way in a single collection from which you can easily select when you want to send photos to a new person. In fairness to people who ask you to unlock when you'd already unlocked your private photos for them in the past (BBRTS, Scruff, Growlr) or to send non-profile photos when you'd already sent some photos in the past (Grindr), these services don't always make it possible for people to see the history of such exchanges. BBRTS, for example, deletes e-mails after a set period of time (measured in days, not months), so by the time you re-lock your private profile photos, people may not be able to see the e-mail message announcing that you had once unlocked for them. Private chat history in Grindr is per-device unless you deliberately invoke the (fairly new) chat backup command. People with, for example, an iPhone and an iPad, can't see that you've chatted with them or sent photos before if they happen to be using the other device at the moment. Worse yet, your record that you have sent a tap to another Grindr user disappears after 24 hours. The recipient can see a history of all taps received, but the sender cannot see a history of taps sent more than 24 hours ago. Scruff, for its part, lets free users see the list of people from whom they have received woofs, but only lets paid users see the list of people to whom they have sent woofs. Unless one party takes the step of blocking, it is plausible that someone will tap (Grindr) or woof at (Scruff) the same person multiple times, days or weeks apart. Profile comments like "If I didn't answer the first time, take the hint" are gratuitous. If someone is so horrified by the prospect of being approached more than once, let him block after the first approach! These services ought to function more like customer relationship management systems, which is really what they are. CRM systems are designed to assemble, maintain and show a complete, permanent, structured history of your interactions with each specific person.