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I want to point out for others who might find this thread in the future that the standard of care in the US is now same-day initiation of antiretroviral therapy, for newly-diagnosed HIV positive people who decide that they want to take medications. A person who tests positive should leave the medical office with a starter pack of HIV drugs (and a follow-up appointment to review the initially chosen regimen). Coupled with frequent state-of-the-art testing (4th-generation HIV antibody/antigen tests, or pooled qualitative PCR HIV viral load tests for people at high risk), same-day ART significantly shortens the time to viral suppression. As @Hairypiglet points out, a drastic spike in viral load is expected after infection. Then, viral load drops (though without treatment, not to an undetectable level) and life continues normally for years (even in the absence of treatment). An unarrested initial spike in viral load followed by no, or slower-than-necessary, viral suppression, will not harm the infected person at first. But the wisdom in the field of "cure research" (really, research into achieving long-term viral suppression without frequent medication) is that speeding up viral suppression has long-term health benefits. First, it reduces the burden of inflammation in the body. Second, it limits the "viral reservoir" (virus that isn't killed by HIV treatment, and doesn't replicate, but that resumes replicating the moment treatment stops). If "cure research" continues to advance, people with a smaller viral reservoir will have an advantage. The truth is that some practitioners still aren't offering frequent, state-of-the-art testing, and that few practitioners are willing and able to provide same-day ART when someone tests positive. You will find these high levels of care in San Francisco (where a "Getting to Zero" committee sets policy for all providers, citywide) and possibly in a few other major US cities. If you are at risk of getting HIV, and the issues I've mentioned are important to you, talk with your medical provider about the type of HIV test you are receiving, the frequency of testing, and whether your provider is willing and able to offer same-day ART if you do test positive. Your quality of life in the long-term could depend on where you live and on who provides your HIV prevention/treatment care.

A middle-of-the-road option occurred to me, @bluewind. I hesitate to mention this, as it's definitely not medical advice and people should always do their own reading, discuss with their medical practitioner, etc. to reach an informed decision. With those caveats in mind... When daily dosing is intended, Truvada for HIV PrEP is thought to be much less effective if more than 3 pills are missed in a week. (This is for receptive anal sex; for receptive vaginal sex the margin is smaller and daily means almost daily.) If you renew your prescription now, and receive the same product, maybe you could interleave, taking 4 new pills each week and 3 expired ones. You'd have to spend the €60 sooner, but the expired medication wouldn't be lost, and even if it were no longer effective, you'd have substantial (if not total) protection from 4 new pills a week.

I'd recommend replacing the expired medication if at all possible, @bluewind. If old painkillers don't work, you get a headache, but if old PrEP medication doesn't work, you can get HIV! The article that @Close2MyBro found is reassuring, and it contains a link to the (open-access) study report. Unfortunately, though, it isn't possible to test all drugs, in all storage conditions. What's more, that study involved medicines that had expired two to four decades before 2012. When the study drugs were made, China had not yet cornered the market for ingredients or India, the market for production. Today, those two countries dominate. China's industry is known for corruption and India's, for quality problems. Some variables I'd consider: • Source: Whether you obtained the medication from a pharmacy licensed in your jurisdiction, or from an unlicensed or foreign pharmacy. Some counterfeits have made their way into legitimate supply chains, but licensed, local pharmacies are more likely to sell authentic products. • Brand: Whether the medication is a brand-name product (such as Gilead Truvada or Descovy) or a generic one (such as Teva or Aurobindo Emtricitabine/Tenofovir Disoproxil Fumarate; Teva and Aurobindo are licensed in the US, but other generic manufacturers might be licensed in your jurisdiction). All other factors being equal, the brand-name product is likely to be of a higher quality, because the manufacturer has a reputation to defend. Generic drug manufacturers enjoy little brand recognition. They care about liability, of course, but they don't need to worry much about brand value in addition. Also, they tend not to be headquartered in countries with strict legal systems. • Country of manufacture: This might be printed on the bottle. If not, it shouldn't be inferred from the drug company; for example, over the years, I've received Gilead Truvada that was made in the US, in India, and most recently, in Germany! The Teva generic that I just received was made in Croatia. All other factors being equal, drugs made in the US or in the EU or Switzerland are likely to be of higher quality. And being on the fringe (Canada, future EU hopefuls, etc.) is not an indicator of quality. For example, Canada's generic drug manufacturing industry has been taken over by unethical companies with strong ties to India. Good luck with your decision!

I applaud you. You are opening the door to maximum potential pleasure. The face cannot predict the fuck. I'm a top who does put my face pic in my Grindr profile and who rarely replies to people whose profiles lack clear face pics. It's not that I'm unwilling to pump-and-dump on the spur of the moment, or even to take a chance on a blind date. There's little to lose; at worst, one person says no thanks, we both wish each other well, and we head our separate ways. But what I'm finding lately is that a guy who doesn't include a clear face pic in his profile tends to be living under some kind of constraint, external or self-imposed, that makes for a fraught interaction. Sending a face pic privately, on request, isn't the same as being comfortable showing it publicly. A digital blindfold option might be a fun addition to apps like Grindr. Cumdumps would select tops based on proximity and maybe on profile characteristics. You'd know that they had face pics on file, and that you could tap to reveal their faces if you wanted to. I liken this to trying to remember what shoes people are wearing in video arcades. This habit lets me guess — without being certain — who is on the other side of the partition, taking my cock.

You said it! I'll buy the idea of sex addiction in cases where sex addiction is diagnosed by a licensed professional. That assumes broad professional consensus on the criteria, and the existence of research findings about treatments. (Thanks to @ErosWired for bringing up the question of the DSM!) What worries me is the American tendency toward non-professional diagnosis. For example, most married heterosexual men are sex addicts according to the online infidelity "survivor" community, which comprises the r/survivinginfidelity subreddit, an eponymous Web site, and the blogs of numerous non-professional "experts" (read: jilted ex-wives). The husband is a sex addict if he masturbates; if he looks at pornography; if he glances at a younger woman — or at any woman other than the wife; if he is curious about sex acts that the wife isn't interested in; or if he desires sex more often than she does. Any of these transgressions constitutes "infidelity" and is grounds for immediate divorce. This denial of normal human sexual responses is spilling over into the gay community. The advent of same-sex marriage, coupled with the portrayal, for the first time, of gay characters in mainstream TV shows and movies, means that we too are expected to be sexless romantics. Straight people will now "tolerate" you if you hold hands with your husband, but will marginalize you to a greater extent than ever before, if you fuck lots of nameless men in dark alleys. Why would you still want to do that, they wonder, now that we have allowed you to marry your soulmate and move in next door to us, in the suburbs? What's natural and harmless is for men (and indeed, for people of all genders) to fuck as often as possible, to fuck as hard as possible, and to fuck as many people as possible.

Hot! Young, fertile cum straight from the source is the best, and those guys were also fortunate to get to enjoy your talents. In terms of load size, a few factors might be at play: • Young guys tend to shoot far. (I can still do that but I have to edge a bit first. Some guys continue to always shoot far, even after they enter their twenties.) • Some young guys don't get to cum very often, due to parents or roommates or work hours. You might have been getting 7-day loads. • Well-hydrated guys (of any age) seem to produce bigger loads. This is something we can experiment with on our own.

This drives me wild. 😈 When I'm fucking a preloaded hole, of course I want my sperm to win (and the shape of the head of the penis serves the evolutionary/biological purpose of removing the last guy's semen, according to Robin Baker's Sperm Wars), but I always ask the guy about the other tops who have fucked him that day. "Which top do you hope will be the dad?" Some bottoms favor the best fuck, even if he would disappear or be an unreliable father, some choose the darkest or most different-looking man, to raise eyebrows, and some want to have a baby with the nicest and most stable guy. From the sound of it, you and your husband are both lucky guys!

I agree with @ucOtterTopNC ; the fantasy of impregnating is foremost in my mind when I'm fucking a bottom guy. @DannyBoyCMH is right that it would be a shame to abort any babies that resulted. It's hot to think about knocking up a younger bottom who, once he starts showing, would have to explain to his parents, and go on leave from college to have the baby. As a mixed-race (black/white) top, it's also hot for me to breed guys who are cheating and would have to explain to a boyfriend or partner why the baby doesn't look like him.

@BlackDude, if I understand correctly, you're saying you were no longer having as much fun as you'd hoped at venues like Steamworks, and you feel that young gay people, whom you believe expect perfection, are the problem. I was a frequent Steamworks Berkeley patron, 2010 to 2015 or so (I would buy the old "gym pass" coupons and go two evenings a week). I continued to go occasionally until the pandemic struck. At Steamworks, on Grindr, and in real life hookups in the Bay Area, I have found younger guys (mid 20s) to be more accepting of my race (mixed black/white), body type (bear), and features (beard and long hair), and this, in spite of my age (now mid-40s). The young crowd is the diverse one, in which people of different races, body types, and now also different gender identities, are represented. There are far fewer "perfect" people in the ranks of the young. When I was growing up, white, athletic, hairless bodies were about the only kind featured in advertising, on TV, and in movies. Today's young queers have grown up seeing people of color, larger people, hairy people, people with disabilities, and so on, in the media. As a group, they don't have as many hang-ups about perfection as the generations that preceded them. Yes, it takes them time to discover and experiment with traditional gay sexual spaces like bathhouses and cruising grounds, because they had a much wider choice of social venues when they came out. But I believe they'll figure it out! Either way, I hope you find people and experiences that please you!

I always ask a guy if he's open to my sharing his profile and his public pic, let alone his e-mail address or phone number, before I pass along the information to a friend. (Grindr has headlines, which are optional, changeable, and not searchable. There are no screen names to share. A public photo or some profile details would have to be shared so that a friend could find the guy.) I don't see an ethical issue in discussing past hookups. It is fun to sit side-by-side with a buddy, look at our Grindr cascades, and compare notes. No contact information or private photos are being revealed. I might exercise caution if a guy is cheating, but in that case, he's likely to have a blank profile anyway, and not to come up in the conversation. I'd find it odd if someone passed along my e-mail address or phone number without asking, but it wouldn't bother me because in the worst case, I could easily mark all mail from a given address as spam and have my phone ignore or block iMessages or text messages from a particular number.

You hit the nail on the head, and you write beautifully and humorously! The thing about gay men who try to imitate heterosexual husbands and wives from 1950s suburban America is that they end up becoming bathhouse patrons. They get tired of birthday sex on clean sheets, in the missionary position. They sneak away from the dog, the kids, the neatly-kept suburban tract home (or the trendy condo in the city) for proper, hard fucking in video arcades, backrooms, dark alleys, parks and bathhouses. These guys have so much pent-up desire and guilt that they will do almost anything once they get started. Heteronormative gay marriage is a boon to public and anonymous sex.

Plenty of young people fuck in bathhouses. Many bathhouses offer discounts and theme nights to attract them. It's the young crowd that's increasingly diverse. Racism, body shaming, gender bias, etc. will always be a fact of life, but for the first time, queers of all colors, sizes, and genders are visible, and the community (if you can call it a community) is secure enough from acute external threat that there is time to confront internal divisions. Divisions remain, but they are acknowledged now, and it is becoming less and less acceptable to write people off because they don't conform to an old ideal of beauty. If an institution like Steamworks Berkeley survives, it will survive on the patronage of Mr. Imperfect. Yes, some people who grew up using gay.com or, a decade later, Grindr, have to go through a discovery process to find bathhouses. These generations are already rediscovering spontaneous public sex with strangers. Easy sex is in our blood! Given economic pressures, young people are more likely to live with roommates and less likely to be able to host privately, so it's only a matter of time before they realize that bathhouses are ideal places to play. Same-sex marriage along monogamous, heteronormative lines is a threat, but biological reality — sexual attraction to more than one person — eventually breaks through.

This is a question for a doctor or other health professional licensed to provide HIV PrEP care. Worth noting: • PrEP no longer refers to just one type of pill. Two two-drug pills are already approved for PrEP in the US. Descovy has one drug in common with Truvada and another that has been reformulated. Injectable drugs, recently approved for HIV treatment in the US, have also been studied for prevention and are likely to be approved for this use soon. • Serious liver side effects are rare in people who use Truvada or Descovy for HIV PrEP, and who do not also have Hepatitis B. Truvada was approved for HIV treatment long before it was approved for HIV prevention, so it's vital to distinguish studies of Truvada in HIV-positive people (who take one or two additional HIV drugs) from studies of Truvada in HIV-negative people (who do not take any additional HIV drugs). The LiverTox database, from the US National Institutes of Health (NIH), is one place where anyone can read about the liver effects of drugs. The database references medical studies, which are much more reliable than individual anecdotes. Here are links to the entries for Emtricitabine and Tenofovir, the two drugs in Truvada: [think before following links] [think before following links] https://www.ncbi.nlm.nih.gov/books/NBK548261/ [think before following links] [think before following links] https://www.ncbi.nlm.nih.gov/books/NBK548917/ This is for interest only. Again, professional medical advice is in order.

Though advance negotiation is important, people who practice withdrawal, play "just the tip", etc. have less control over the outcome than they believe. If a known partner agrees to pull out, he probably intends to and probably has the necessary self-awareness and self-control. Even so, you might make him feel so good that he will cum inside you by accident, or he might make you feel so good that you will beg him to breed you. With a new partner, all bets are off. He might be a heavy precummer. He might blow the first spurt inside, either deliberately or due to limited self-awareness and self-control. Some guys practice not seizing up and not vocalizing when they nut, so he could deliberately blow his whole load inside before you even realize. Another factor is that once they have crossed the barrier, two people are unlikely to revert to pulling out, next time they fuck. Just ask your straight friends — female as well as male! Heterosexual sex offers a useful analogue. Withdrawal is an effective birth control method but the difference in effectiveness between "perfect use" and "typical use" is substantial, according to Planned Parenthood. If HIV prevention is your goal, PrEP for you and/or your HIV-negative sex partners is highly effective, as is choosing HIV-positive partners with an undetectable viral load. Of these options, PrEP for you is the only one that you can verify first-hand.

Great video suggestion, @DenverBtmDude! Amazing! I thought this existed only in porn films. It seems like the ultimate setup for tops who want to enjoy multiple holes.

So hot! People like this who host private glory holes, and who not only suck cock but also get fucked bare, are true heroes, providing a needed outlet for so many men.

Yes, people interested in HIV PrEP should see a doctor for professional advice. In evaluating what they read online, they should be careful to distinguish empirical data (good), anecdote (suspect) and speculation (useless). Even empirical data require interpretation, which may require specialized knowledge. For example, in a thread about PrEP side effects, a well-intentioned poster responded to an anecdotal report of a severe side effect by looking up Gilead's consumer Web site for Truvada, which says that headaches are the most common side effect. The person didn't report the percentage (quite low), and didn't realize that, in medical studies, side effects are grouped by severity. Debilitating headaches are decidedly not a common — let alone the most common — side effect of Truvada. Other posters compared PrEP and PEP (or speculated), under the incorrect assumption that HIV PEP stands for some uniform drug regimen. As important as it is to see a medical doctor, I believe that prospective and current PrEP users should also acquaint themselves with the CDC PrEP guidelines (or local equivalent, for people outside the US). For example, if you read the guidelines, you'll know that an at-risk gay man should receive HIV and STI testing at least every three months. I have seen examples of PrEP users — and PrEP providers — who are lax about that. The CDC guidelines follow directly from empirical data. The CDC publishes materials at all levels, from brochures to the written guidelines to the "provider supplement". If you're interested, revisions are available for review and public comment right now. They cover intermittent dosing ("2-1-1") and anticipate longer-acting injectable HIV PrEP drugs (already approved in the US as an HIV treatment option, a very exciting development!).

Sometimes I will offer my first name and ask the other guy's first name early in a Grindr chat. We've become accustomed to not being addressed by name, or to having our names used insincerely ("Mr. ... um ... Sm-ith, is that how you pronounce it? Thanks for shopping at Safeway," spoken by a distracted teenager at the checkout counter; "Dear Joe Smith, PBS depends on your generosity..." because the Web form didn't have fields for salutation and just last name; or "You're the birthday boy or girl," sung mechanically by the glockenspiel at Wall E. Weasel's in the Simpsons). If the guy wants to talk about topics other than sex, I'm happy to engage, and to begin seeing him as an individual. On the other hand, I also appreciate guys who are direct about sex. There's no need to exchange names when a cute bottom 2,500 feet away opens with "Fuck me rn?" I might ask his name when my load is dripping out of his hole and he's getting up to leave, but anonymity can be hot in and of itself. I confess that I've also had a few regulars over the years whose names I'd forgotten after the first or second encounter. When you only communicate that you're horny today and free at a certain time, and then you fuck or suck, and bolt, there really is no need. It's a paradox, but those ongoing, if casual, connections can run quite deep. Not having to talk much, and not needing to remember each other's names, reflects a level of familiarity built up over time.

Health insurance regulations and the drug marketplace have changed, likely making both points moot. First, HIV PrEP for at-risk individuals is now a preventive service. As of January 1, 2020, the vast majority of health plans must cover PrEP-related visits, tests and medication with no cost sharing (no deductible, no flat-dollar copayment, no percentage coinsurance). It appears that you are in California. Our state's Department of Managed Health Care issued specific guidance to health plans on this point. Although it's likely that insurers are taking of advantage of individual patients' lack of knowledge, and that doctors, test providers and pharmacies are making coding errors, you won't have to remind these parties more than one time. The CA DMHC is very strict. July 8, 2020 reminder letter to California health plans: [think before following links] https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL%2020-026%20-%20Preventive%20Coverage%20for%20HIV%20Preexposure%20Prophylaxis%20(7_8_20)_1.pdf?ver=2021-05-07-105930-913 Second, now that generic versions of Truvada are available, it's unlikely that your health plan covers brand-name Truvada. If you have a grandfathered health plan (about the only kind of plan that is not subject to the preventive care rules) and your doctor selects Descovy (a newer, still-patented alternative to Truvada, with one of the two drug components reformulated) you can still use Gilead's assistance programs. For patients who can use ordinary commercial pharmacies, this is as simple as calling a toll-free number one time, receiving a numbered card in the mail, and showing the card each time at the pharmacy. Teva introduced the first generic version of Truvada in the US, but it is almost-full-price. Their assistance program was interrupted at the end of March, and then renewed through the end of April, when it expired again. Whether it will continue is uncertain. After Teva's exclusive licensing deal with Gilead ended, Aurobindo introduced what we've come to expect of generics, a truly low-priced product (just over one dollar per daily tablet). Aurobindo does not have a patient assistance program. But once again, the vast majority of insurance plans must now offer PrEP completely free, so paperwork, drug price considerations, and drug company patient assistance programs are thing of the past.

Me too. I used to try to educate such people (I volunteer with a public health organization that does HIV prevention research, attend conferences as a community member, read study protocols and research papers, and have participated in two major studies), but I now just wish them well and tap the block button. Having to explain PrEP, or U=U, to a fellow Grindr user is a boner-killer. The conversation is more likely to result in insults than in sex. I wonder why some people are incapable of performing a Web search and reading a leaflet from the CDC or another reliable source, or just asking their own doctors to explain PrEP and TasP. People who refuse to sleep with PrEP users or undetectable Poz guys could be increasing their risk by favoring partners who don't have to get regular testing. They're also turning down experienced sex partners. You don't go to the trouble of following a PrEP regimen if you don't fuck a lot, and you don't become Poz by staying home and jerking off!

Cum kissing, fuck yeah! This would almost make me consider marriage again. 😏

This sounds like PrEP shaming. As @Cutedelicategay and @bluewind point out, sex partners not on PrEP are the ones not receiving regular, frequent HIV and STI tests under an established, ongoing relationship with a medical professional. If the people who turned down your friend were knowledgeable about PrEP — which isn't the case — they could doubt that he was actually following a PrEP regimen. For example, when I see HIV Status "Negative, on PrEP" in a Grindr profile but Last Tested is blank or the date is many months in the past, I realize that the person is not properly following a PrEP regimen. According to the CDC (I'm in the US) PrEP guidelines, sexually active/"at-risk" men who have sex with men should receive HIV and STI testing at least every 3 months. Some PrEP users obtain their medication from unlicensed or foreign mail-order pharmacies, through friends, or by taking advantage of same-day PrEP initiation at a clinic but not returning for follow-up. Many stop taking their medication but still think of themselves as PrEP users (rather like putting on a bicycle helmet but not buckling the strap or, in today's times, wearing a mask but leaving your nose uncovered). Some PrEP prescribers don't bother to insist on quarterly HIV and STI testing. Others (especially small, private practices) are not equipped to monitor PrEP patients properly. Again, PrEP shamers wouldn't have these caveats in mind. I agree completely with your assessment of Canadian social mores. I grew up in Canada in the 1970s and 80s, in the country's largest and ostensibly most progressive metropolis, no less. I maintain close ties and return regularly. In the 1980s, we were still not far removed from "Toronto the good", the label from the 1950s. Government liquor stores were closed on Sundays. Indeed, almost all Sunday shopping was illegal. Only convenience stores and small shops on a handful of designated tourist streets could open. Government-funded television portrayed premarital sex, teen pregnancy, homosexuality, and divorce as life-destroying. Even program[mes] with a modern, progressive veneer, like Degrassi Junior High and Degrassi High School, had the paradoxical effect of making sex seem dangerous and wrong. In all of their former colonies, the British left a legacy of anti-sex laws and morals. Canada began to repeal these laws in the late 1960s, but the anti-sex morals remain. Canada placed severe restrictions on abortion well into the 1980s, and was even slower than the US at providing widespread access to medical (pill-based) abortion (literally just a year or two ago). Predictably, Canada lagged far behind the US in approving Truvada for PrEP, and in implementing PrEP care. Paying for PrEP remains a problem in Canada because (unbeknownst to Americans), there is no government-sponsored prescription coverage unless you are a senior, a person with a disability, or someone with a very low income. Canada, as far as GLBT people are concerned, remains a paradox. We gained legal protections in Canada many years before we did in the US, but social acceptance and practical supports lagged.

If your son tells you he wants to be a trucker when he grows up, you'll know why. 😏 In all seriousness, this is really hot! I love the way you arranged everything, from the location to the cell phone plan to the schedule of regulars. The world needs more people like you; providing pleasure takes dedication.

I shouldn't have assumed that you are based in the US, of course, @1000GUYS. You used "maths" in another post, so perhaps you are in the UK. I know that France has a standard, nationwide emergency room protocol for PEP, but I don't know the situation in the UK.

As for Post-Exposure Prophylaxis, if you are worried, why not talk with your doctor, or go to a GLBT-friendly clinic? But do not wait! If you and your doctor decide that PEP makes sense, starting within 72 hours of the risky sexual encounter is vital. If you are unable to see your doctor or visit a clinic, any hospital emergency room can initiate PEP. In the US, it is the standard of care after a risky sexual encounter, and there is a protocol. Nevertheless, in conservative states and cities — including even the suburbs of progressive cities like San Francisco — you might have to be very assertive. Even if they have up-to-date knowledge of HIV prevention and treatment, experience prescribing HIV drugs, and experience serving GLBT patients (the combination of these three traits is unlikely), emergency room physicians tend to be reluctant to initiate PEP (or, for new HIV-positive patients, to initiate treatment on the day of diagnosis, as is now recommended), because they cannot provide follow-up care. And, unlike PrEP, for which the choice of drugs is simple because only two two-drug combination pills, Truvada and Descovy, have been approved so far in the US, PEP requires complex decision making. A wide variety of drugs can be prescribed, in combinations of three. (In the ideal case, the patient can find out from the known-HIV-positive sex partner which drug regimen he uses, and a choice can be made that will minimize the chance of resistance.)