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At the bottom of this reply to another thread, I quote the intermittent Truvada for PrEP regimen from the US CDC PrEP guidelines. Note that intermittent dosing, which involves a 2-pill loading dose after a break of 7 or more days, is only for Truvada (or generic), not for Descovy at this time. In general, your medical provider is the one to talk to, and this is doubly true if you had an interruption in daily PrEP without intending to start intermittent dosing.

With an ass as irresistible as yours, you are going to attract loads from so many tops that you'll have a hard time knowing who the father was! 😉 If I were lucky enough to get to be one of your breeders, maybe you'd know it was my baby, from skin color.

I think you should weigh your sexual needs against the potential consequences for your partner, and for your relationship. First, it's OK to want sex with new people. It also sounds as if your partner is generally aware of, and not entirely closed to, your desire to get bred by other men, since you guys "used to play with others". Why not ask him, in this case? It's better if he's currently aware of the risks and is taking normal, sensible precautions for any sexually active gay man (regardless of any agreement to be monogamous): getting regular and frequent HIV and STI tests. His awareness may have declined in the two years since you guys last played with others. For yourself, in the long term: If you have difficulty getting PrEP, it's also likely that, in the small chance that you get HIV from a one-time encounter, you'd also get substandard HIV care: slower diagnosis and slower initiation of treatment. Find the best sexual health care for gay men in your country. Have a solid HIV and STI testing regimen in place. Find out what kind of HIV test is being used — a fourth-generation antibody+P24 antigen test that can detect a new HIV infection in few weeks, or a second-generation antibody test that tells your status as of a few months ago. Insist on getting the range of STI vaccines that are the standard of care in some parts of the world (vaccines against Hepatitis A, Hepatitis B, and HPV). Find out how quickly HIV treatment is initiated, for people in your country who are newly infected. I agree with parts of what @MuscledHorse and @cman54 have said. One way to put their ideas together would be to say that, if in the end you need to get fucked by other men to be satisfied sexually, you should do that, and you will, but your partner should be aware, and there's a chance that he will end the relationship. If it comes down to that, no matter how much you "love the guy", don't stay in a relationship that prevents you from having the sex you want.

This news makes me really happy, @briefbouy. It sounds as if you have found a great new doctor. Sounds like a dream vacation! Out of curiosity, where are you planning to travel next? 😉

You sound perfect! As a husky bear you must have childbearing hips. Hopefully you like repeated, hard fucking, even while you are pregnant. Can I trust that you are going to carry my babies to term, and then do a good job looking after them? How many children do you want to have?

I post my status (neg and on PrEP) and my last HIV/STI test date (start of every month) on my Grindr profile. I don't care about other people's HIV status (other than that I tend to favor Poz people, who, in my experience, are edgier and have more sex), but I do appreciate it when ostensibly neg people are on PrEP, and when a person, regardless of status, has a habit of regular STI testing. I don't ask about status. I was fucking a young guy last weekend. We were cuddling after I dumped my third load in his perfect little ass, and he said, "You didn't ask my status." He volunteered that he is Poz and reassured me that he is on medication and has an undetectable viral load. I think he was surprised when I told him that I appreciated the disclosure, and that I don't care, except in that I hope, for his own sake, that he is healthy and happy. TasP and PrEP exist in large part so we don't have to worry about status anymore. To me, it's the habit of looking after one's sexual health, to protect oneself and one's partners, that matters.

Congratulations on starting injectable PrEP, @1stimebare, and thanks for sharing your experiences. Check the drug leaflet (available on the manufacturer's Web site) or the US CDC PrEP guidelines (latest revision: 2021) for information about how soon you are protected. You (or your provider, more likely), could also check the HPTN 083 study design, considering carefully the purpose(s) of the lead-in period in that study. Your provider is likely being conservative.

You will have fun doing this! As a top I once collected used condoms from a street where straight guys go to fuck sex workers, dumped the contents in a BBRTS bottom's ass, and fucked him. Knowing that he had sperm inside him from three random men, plus me, was a huge turn on. I don't think there's specific, relevant research on this point, but given the moist, warm environment inside a condom, I would proceed as if I'd barebacked with multiple people of completely unknown sexual health status. (For me, that would mean remaining on PrEP and promptly getting STI tests after playing — or timing high-risk play about a week before my monthly STI tests.)

As a top I find that when I'm extremely horny, I get less cautious about public sex. Thoughts of getting serviced take over. If I'm only moderately horny and playing, I'll maintain situational awareness. But when it has been a few days since my last nut, getting off becomes my focus and I stop paying attention to people who might be watching or listening, or who might walk in and interrupt. Thankfully, I'm ready to dump my cum in the guy's ass or down his throat very soon after my mind enters that stage. I've always wondered whether the lead-up to orgasm is similar to the fight-or-flight instinct, which briefly causes the brain to shut out all extraneous influences.

I'm sorry to hear about the continuing run-around. I am, however, glad that you are enrolling in ViiV's copyment assistance program. That should be a first step for any privately-insured person who is about to start Apretude. The out-of-pocket cost for most insured people will be zero under the Affordable Care Act's preventive care mandate. In case someone has a grandfathered health plan, or in case a plan subject to the preventive care mandate illegally tries to charge a copayment or coinsurance, and/or to apply a deductible, the program will cover those costs while the person waits for resolution of a health plan grievance and an eventual complaint to a state health insurance regulator. Medical care that improves someone's safety and quality of life is worth the effort. The battle will only have to be fought once. The law is unequivocal and a state regulator is bound to give a non-compliant insurer a firm slap on the wrist. It just takes paperwork and time. Use the copayment assistance program in the meantime!

I don't understand the endless haggling. Insurance is only one way to get PrEP at no out-of-pocket cost. Long ago I mentioned many different solutions. Medicaid was brought up because one commentator from a state that has expanded Medicaid probably meets the income criterion. Very low income earners in states that have not expanded Medicaid can use one of Gilead's two patient assistance programs. One program, in which any privately insured person at any income level can enroll with a 5-minute phone call, used to be helpful for paying copayments, coinsurance and deductibles, when those still applied to PrEP care. That program is no longer of much use, due to the preventive care mandate and to the shift, by virtually all insurers, from covering brand-name Truvada to covering generics. But the other Gilead program pays the full cost of Truvada for people who are not insured. This program has an income limit, so an application is required. Because these clients are uninsured, there's no insurer to force generic substitution. The program works specifically because the prescriber writes "dispense as written", requiring brand-name Truvada, whose cost is then paid entirely. The same Gilead program also pays the full cost of Descovy (usually prescribed in case a prescriber finds that a patient cannot use Truvada). As I mentioned in the Apretude thread, ViiV, the manufacturer of the new PrEP injectable, has the same dual structure for its patient assistance programs. Just as with Gilead, ViiV will pay the full cost of Apretude for an uninsured, low-income patient. (And before we get fixated on testing costs, Apretude requires much less initial and ongoing safety-related testing than Truvada or Descovy, and HIV and STI tests are available for free or for a very low cost from public health departments and community clinics all over the country.) Please stop perpetuating the myth that there's no way for some particular groups to afford PrEP. And if you want PrEP but believe you can't afford it, go to your county health department or to a community clinic and ask for (federally funded) "PrEP navigation" services. Navigators know all of the options I've mentioned, and more. Please, don't play any further part in discouraging people from seeking available help getting PrEP!

Beauty and absolute perfection! 😉 Thank you for going above and beyond by not only telling what kind of underwear you wear, but also showing.

There is controversy in research circles about the protective role, if any, played by circumcision. One of the seminal* African studies that someone posted on BZ, that attempted to estimate transmission risk per encounter, turned out to have a lively paper trail in the journal that published it. A letter to the editor argued for circumcision as a public health measure, but the researchers replied that that would be a misinterpretation of their data (confounding). In their study population, circumcision was associated with being Muslim, which was in turn associated with lower levels of risky sex. * No pun intended. The risk rates from the study in question are used everywhere, and often without attention to population differences (such as, in most of Africa, studying sex between men and women, rather than sex between men). The risk rates were used, for example, as inputs to a mathematical modeling study that predicted drastic transmission of HIV by people with an undetectable viral load. Not a decade later, real, and in the case of gay men, population-specific, research found zero risk, proving U=U. When reading an article that depends on a key study, it's important to read the original study report and see whether it's applicable or was just convenient to use. I'll be curious what you find when you size up the verywellhealth.com article.

@chipygmalion80, what's important is that everything changed once states (like Oregon) opted to expand Medicaid under the Affordable Care Act. The kinds of rules you describe were indeed insulting and unfair, and they applied even in rich states like California, before the ACA and Medicaid expansion. They no longer apply. Most of all, there are ways for patients in all different circumstances to get PrEP free of charge in the US. I listed many specific approaches, some involving insurance and some not, in an earlier post. A "PrEP navigator" in a community clinic or a public health department knows of even more strategies. (PrEP navigator positions, now common throughout the country, are paid for with federal funds.) In the US, cost is not a barrier to PrEP access. Perceived cost is, and it will remain so as long as people rely on anecdotes instead of seeking information about real and specific policies and programs that exist today (for people who decide that they want PrEP, a personal decision, obviously). The Europeans do well with universal health coverage but it too has gaps (which is not to say that it is worse than the American alternative, only to point out that some of the same populations are underserved). Europe has a thriving labor market for undocumented immigrants (in France, Switzerland, Germany, etc., the people who clean the fast trains, factory-bake the tasty croissants, do the unskilled construction work for the shiny new office towers, and lovingly care for the elderly at home). Undocumented immigrants are not served by European health insurance schemes; it's as if the people don't exist. As far as serving LGBT people goes, European countries have been much slower to approve and cover PrEP. The US is far ahead, in terms of having approved all three empirically-proven HIV PrEP products: Truvada (or generic), Descovy, and Apretude (the new injectable) and having mandated that insurers cover all PrEP-related services at no out-of-pocket cost. (This is the preventive care mandate of the ACA.)

I respect your posts and opinions, too, @BBArchangel. We'll have to agree to disagree on this issue. I never challenge the lived experiences and emotions of people who feel hurt when a partner wants to, or does, have sex outside the relationship. I do, however, object to the idea that the partner who wants sex outside the relationship is defective. One can use "cheater" to describe a person who has sex outside a relationship, but epithets like "liars or whatever you are calling yourselves" presume that one person's wishes are completely invalid and that the other person's wishes are valid — in other words, that one partner is all wrong and the other, all right. Every partner who can be called a "liar" has a counterpart who could be called a "prude", "frigid", a "control freak", or "boring in bed". Name-calling of course doesn't help. The problem is that two people (not just one) are finding out that their relationship isn't perfect. It's a hard problem, and in most cases, it can't be solved by digging in deeper on monogamy. The partner who asks for an open relationship is being honest, and is taking a huge emotional risk. The partner who refuses is taking no emotional risk, and is dismissing the other person's desires. Do we really expect one partner, who wore the "bad boyfriend" target on his back when he asked for an open relationship, to then put on the "lying, cheating boyfriend" target (with an even bigger red circle in the middle), disclosing that he has given in and fucked another guy? Meanwhile, the other partner, who refuses sex and refuses to allow sex with others, gets to keep wearing the "perfect boyfriend" wings, and to add the "innocent victim" halo when the sex-starved partner cracks? Trust is definitely important, but each individual still has to be realistic and be responsible for his own safety. Research on straight married people inevitably uncovers high rates of infidelity. Even though participants can easily lie in this kind of survey research, they admit infidelity. These are straight people, who have longer experience with formal, legal marital relationships than do gay people, who have fewer total partners, and who have less access to casual sex (due to social mores and pregnancy risk). It's even less realistic to assume fidelity in a gay relationship. As for safety, it makes sense to trust that a positive boyfriend won't transmit HIV if he's virally suppressed and you watch him take his medication every morning. If the man of your dreams is negative, stay on PrEP yourself! Whether he's neg or Poz, it makes no sense to trust that he won't transmit other STIs, because you cannot watch him all day long. Get your STI vaccinations and keep up with your own STI testing routine! The other thing that gets me — and I'm not saying this of you, or even of this thread, but in general — is that we leave space for people to discuss all kinds of fetishes here, but always drown out discussion of cheating as an erotic fetish (even though it isn't illegal, unless you're in the US military or in a religious fundamentalist country, and even though the forum rules don't seem to forbid discussing it). It's possible, just possible, that some of us find cheating erotic. I can never be cheated on because I don't believe I'm important enough to regulate anyone else's sexual behavior. I can never cheat again because I now refuse to enter into monogamous relationships. Though I have no stake in this game, reading about cheating makes my dick hard. I always politely suggest that people separate erotic discourse about cheating from emotional discourse. It's easy to create a new thread, and even to cross-link two threads. In other online communities, shaming has become such a problem that moderators have had to step in. On Reddit, for example, members of the r/adultery subreddit regularly receive hate-filled private messages from members of r/survivinginfidelity . The rules for the two communities have been updated to say not to quote, cross-reference, etc., and to report hate mail. We don't have that kind of problem on BZ, but instead, the anti-cheaters succeed in drowning out erotic discussion of cheating. I am puzzled that fifty-year-old celibate straight women have a voracious appetite for romance novels about infidelity (the typical cover shows an olive-skinned, muscular, shirtless, long-haired man riding a white horse, come to rescue an innocent, homely, lovelorn housewife) but some gay men don't tolerate any discussion of infidelity. There's room for all perspectives. Is there any reason not to create separate spaces to discuss the erotic and the emotional dimensions of cheating?

@1stimebare, the Affordable Care Act, and laws in some states, give you appeal rights. Even if the denial letter ends up being superseded by an approval, it's a good idea to start the appeal process now. The letter should indicate what to do, but you might have to check with your state's health insurance regulator. You will get lots of conflicting answers from people who do not have final authority. An insurer's interest is always to cover as little as possible. The usual practice is to deny everything, even if the coverage is required by law. Clerks are trained to deny requests and are not given the knowledge or the authority to do things right. Delays, inconsistent answers, and so on, are part of the insurer's strategy. Most patients don't complain, so the strategy usually works. Waiting to start PrEP increases your risk of HIV infection. Don't hesitate to speak up! Your state's health insurance regulator should have a Web site and a phone number where you can get information about your rights.

This is ideal from an evolutionary perspective. Sperm competition means that, from among the various men present at your gangbang, the man with the strongest sperm would prevail.

I would recommend a two-pronged strategy, @1stimebare. 1. Enroll now in the manufacturer's patient assistance program for insured people, which should cover those out-of-pocket costs for now. [think before following links] https://apretudecopayprogram.com/ 2. Contact your state's health insurance regulator and bring up the Affordable Care Act's preventive care mandate. Unless some law or regulation requires you to first go through your insurer's internal dispute process (typically called filing an "appeal", "grievance", etc.) before the state regulator will intervene, skip the insurer's process, as it is a waste of time. As far as waiting until the prescription is written to find out the cost, whoever told you that is incompetent. Apretude is dispensed by a pharmacy based on a prescription, but it's dispensed and delivered to your doctor's office for them to inject. You don't pick it up yourself and pay at that time. This is why it's important to enroll in the assistance program beforehand and communicate the information to your doctor's office, for them to pass along when they interact with the pharmacy that will supply your dose of Apretude. (It's a small network of specialty pharmacies, and the manufacturer has a Web portal that your doctor's office and the pharmacy must use. Your doctor's office will enter your insurance information and your copay assistance program enrollment information.) Good luck and please keep us posted!

Trust is not an effective method for preventing HIV and STI transmission. There is no empirical evidence that it works. There is plenty of empirical evidence, on the other hand, that people in relationships have sex with other people. Any sexually active gay man is in a high-risk category, and should: receive frequent, regular STI testing; receive regular HIV testing (if negative) or HIV viral load testing (if positive); use PrEP for HIV prevention (if negative) or receive HIV treatment (if positive); and get all available STI vaccinations (including the Hepatitis A, Hepatitis B, and HPV vaccines); to protect his own health. These measures are all "standard of care" in the US, and should of course be undertaken with the support of a licensed medical professional. Medical studies prove that these measures reduce the spread of HIV and STIs. A fascinating finding in the PARTNER 1 and 2 studies, in which almost 900 mixed-HIV-status straight and gay couples had condomless sex over 58,000 times and almost 800 mixed-HIV-status gay couples had condomless sex over 77,000 times, was that not a single HIV infection occurred between partners (the HIV positive partners had an undetectable viral load). Genotyping showed that the HIV infections all resulted from sex outside a primary relationship. People can be upset, hurt, etc. about cheating, but they cannot disclaim responsibility for their own health.

It sounds as if @Dcbbslut123 was upfront with his boyfriend about wanting to open the relationship, and that the boyfriend refused. If the boyfriend isn't having sex with him, and isn't allowing him to have sex with others, then @Dcbbslut123's hands are tied. (And there's also zero health risk to the boyfriend.) Let's not treat the boyfriend as a hapless victim. If he is happy with the relationship as it is, he'll stay, and if not, he'll leave. It is apparent to anyone who refuses an open relationship and withholds sex (if that's what happening) that the other person is meeting their sexual needs elsewhere. Those needs — expressed at the time an open relationship was requested — don't go away. None of this is meant to question or diminish yours or anyone else's personal experiences and feelings about having been cheated on. It's meant to assign equal weight to the perspective of the partner whose sexual needs weren't being met, and who dutifully sought a solution by asking for an open relationship.

Best solution, by far!

I hope your boyfriend will realize what he's missing out on, and what he's been doing wrong. Making any romantic and/or sexual partner feel wanted and desirable is extremely important. No, you are not cold at all. Every person has a right to enjoy their body, including sexuality. Your boyfriend refused to provide you sexual pleasure, and then refused to let you enjoy sexual pleasure with anyone else. He is the one with the problem, not you. Objectively, his behaviors are self-regarding (if not also selfish) and controlling. I believe that they are also stupid, immature, and unhealthy. I hope he wises up in time to save your relationship. If not, you're already well on your way to feeling attractive, proficient, and confident as a lover, and you are not wasting another minute living without the sex you want to have.

See my post higher up in the thread, which explains how to decide whether you need to repeat the 2-pill loading dose or not. The post also links to the US CDC PrEP guidelines. Please be sure that your PrEP provider is aware of your current dosing, and please be sure that you are using Truvada (or generic) if you experiment with intermittent dosing. A medical provider should be the one who explains the "2-1-1" regimen for Truvada for PrEP, including special cases. It is your provider's responsibility.

Your wry reply to @1999bottom made me smile. You and I both answered @Mojojo's original question with risk reduction information, and you added parameters for making choices. But I like @1999bottom's answer too, because it is totally honest. Sex is an irrational activity. If we start by acknowledging temptation, pleasure, fear of the forbidden, etc., we can then move on to risk reduction. Does the first bare load motivate someone to go on PrEP (as one example of a risk reduction strategy), or does going on PrEP (which requires advance planning, particularly for people not living in a place like San Francisco with cutting-edge, GLBT-friendly health services) motivate someone to take the first bare load? Ditto for other individual and/or collective risk reduction strategies like STI vaccinations (for people not old enough to have received them as part of routine pediatric vaccinations) and setting up regular, recurring HIV and STI testing.

I agree with @1999bottom. If you are worried about HIV, you can also visit a GLBT-friendly health clinic to see whether PrEP is a good choice for you. The most up-to-date clinics (typically in major urban areas like San Francisco and New York City) offer same-day PrEP initiation. This, combined with intermittent ("2-1-1") Truvada (if a medical professional finds it appropriate for you) could get you started taking bare loads in hours, with no worry about HIV. (If you were prescribed a daily regimen, you would have to wait to be safe.) If you are sexually active, regardless of your decision about barebacking, be sure to get HIV and STI tests on a frequent and regular basis, and to talk with a medical professional about available STI vaccinations (Hepatitis A, Hepatitis B, HPV, meningitis). Hopefully you have a well-informed and conscientious medical provider who has already brought up these things. Let us know if you take this daddy's load now or in the future. 😈