PrEP and PEP

[Guest virgoz]

Guys, some advice please cause I've got no idea about this.

I'm trying to get my cock into this hot hot guy who says Hes been on PreP for a few months, but still won't take me bare cause I'm not on meds. And I'm NOT using a condom!! He is kinda wavering, cause we get along well and he is a real cockslut.

Questions: how much protection does Prep provide a bttm? Does it provide more protection for a Top? And is it the same as PEP?

Thx

[BearBackCO]

PrEP and PEP are not quite the same. PrEP is taken on a regular basis before exposure to HIV, PEP is taken as an emergency measure after being exposed. PrEP only "protects" to a certain point...if you fuck him bb, there is a good chance that your HIV will get in to his blood stream and infect him. With PrEP, the hope is that the meds will limit the ability of the HIV to take hold and multiply. As I understand it, It could still be possible for it to get in to some places and hide, so if he goes off PrEP, there is a chance that what little bit of HIV may have survived could come back and get him. At least, that is my unprofessional understanding of it.

[Guest JizzDumpWI]

That is utter bull.. If PrEP guy is regular in his use you are not going to infect him. I take it and would not hesitate to take your load.

[BearBackCO]

OK. I went out to the CDC website and looked it up. The differences between PrEP and PEP are correct. The statement about how PrEP works is correct (limits the ability of HIV to take hold and multiply). As for the statement about going off of PrEP, I cannot find information on that, so I will withdraw that part of the statement. The CDC also shows the stats on the effectiveness of PrEP (73% - 92% effective for M2M). Here is a link to the CDC's website for more information: http://www.cdc.gov/hiv/basics/prep.html

[bearbandit]

The reports I've read have indicated that the protection from PrEP is broadly equivalent to that of using a condom. Not 100%, but near as dammit. In the case of one poz/one neg, if the poz guy is on meds and undetectable, he's going to be shooting blanks so in that instance the protection is as near total as you can get.

I suppose in this specific instance the important thing is what's your VL virgoz? The lower your VL, the more protection his PrEP will give him. Since he's been on it for few months, the protection should be near total anyway, providing he's been taking it regularly.

[Guest JizzDumpWI]

OK. I went out to the CDC website and looked it up. The differences between PrEP and PEP are correct. The statement about how PrEP works is correct (limits the ability of HIV to take hold and multiply). As for the statement about going off of PrEP, I cannot find information on that, so I will withdraw that part of the statement. The CDC also shows the stats on the effectiveness of PrEP (73% - 92% effective for M2M). Here is a link to the CDC's website for more information: http://www.cdc.gov/hiv/basics/prep.html

Actually in studies where PrEP compliance was verified by blood levels of the drug there were no infections. true though that a bad flu or potentially an STI; effectiveness can wane just as similar events can raise VL and lower CD4 of an HIV infected guy on meds.

[ffoz]

The reports I've read have indicated that the protection from PrEP is broadly equivalent to that of using a condom. Not 100%, but near as dammit.

..

PrEP is broadly equivalent to that of using a condom. No offence. But, are you serious?

[ffoz]

http://www.afao.org.au/about-hiv/research/biomedical-prevention/pre-exposure-prophylaxis#.UmHwpFP4Lng

http://www.starobserver.com.au/news/landmark-drug-trial-plan-for-australia/87266

Just a couple.

[Guest JizzDumpWI]

The reports I've read have indicated that the protection from PrEP is broadly equivalent to that of using a condom. Not 100%, but near as dammit.

..

PrEP is broadly equivalent to that of using a condom. No offence. But, are you serious?

who do you imagine you might be offending... And why?

[drscorpio]

The place where PrEP beats condoms is this - If you only use condoms some of the times, they offer almost no protection over the long run. You can miss 2-3 doses of PrEP meds in a week and still have protection.

In any case, there is no reason to go through all of this here. There is a whole sub forum on PrEP where all of this has been discussed and where links to all of the documentation are posted. I am a little surprised the moderators haven't moved this thread yet.

[wood]

Guys, some advice please cause I've got no idea about this.

I'm trying to get my cock into this hot hot guy who says Hes been on PreP for a few months, but still won't take me bare cause I'm not on meds. And I'm NOT using a condom!! He is kinda wavering, cause we get along well and he is a real cockslut.

Questions: how much protection does Prep provide a bttm? Does it provide more protection for a Top? And is it the same as PEP?

Thx

As much as you may want it, if he doesn't, then its not your call. Also are you sure he's on PrEP? it says you are in Austraila, and PrEP isnt approved there yet as far as I know.

[wood]

PrEP and PEP are not quite the same. PrEP is taken on a regular basis before exposure to HIV, PEP is taken as an emergency measure after being exposed. PrEP only "protects" to a certain point...if you fuck him bb, there is a good chance that your HIV will get in to his blood stream and infect him. With PrEP, the hope is that the meds will limit the ability of the HIV to take hold and multiply. As I understand it, It could still be possible for it to get in to some places and hide, so if he goes off PrEP, there is a chance that what little bit of HIV may have survived could come back and get him. At least, that is my unprofessional understanding of it.

Well you are mostly incorrect. PrEP taken correctly is roughly 99% effective in preventing HIV transmission. PrEP simply makes it that the HIV virus cant infect, and gain a foothold in your body. The medication prevents the virus from infecting and replicating. If it cannot replicate, the immune system is eventually able to kill the copies that may have got into the body through exposure. This is also why consistent dosing is so important. Say you take it on weekends and go to a bathhouse, then think you dont need it during the week. When the drug levels drop enough, your immune system may not be able to fight off those virus copies that are in your system because they are starting to replicate, then you become infected. But, if you are consistent with taking it, the virus copies are eventually destroyed by the immune system. Its kind of the same reason why HIV transmission is nowhere near 100% even with exposure. Your body can fight off small exposures, its when it reaches a critical mass with number of virus copies, or if someone has a compromised immune system (IE a cold) that infection becomes easier.

The reports I've read have indicated that the protection from PrEP is broadly equivalent to that of using a condom. Not 100%, but near as dammit.

..

PrEP is broadly equivalent to that of using a condom. No offence. But, are you serious?

In terms of HIV transmission it is. When you consider condom failure rates, if PrEP is taken everyday as directed, its actually more effective, no condom can boast a 99% non failure rate in real world usage. However it must be noted that PrEP does nothing against any other STI's.

[bearbandit]

The place where PrEP beats condoms is this - If you only use condoms some of the times, they offer almost no protection over the long run. You can miss 2-3 doses of PrEP meds in a week and still have protection.

No: What's coming out of the UK studies is that PrEP has to have the same adherence levels expected of someone with HIV. Percentage-wise that's in the high nineties, meaning you can really only afford to miss a dose a month. There is work going on to reduce the drug burden, with lower frequency drugs being a particular focus. My personal opinion is that after daily, the next logical step is weekly - every other day and it's too easy to wonder if it's a drug day or not. Adherence is always easier if it can be tied to another regular life event: I tie my antivirals to my diabetes medication. I know that if I don't take that I'm going to feel like shit, whereas if I miss a few doses of anti-HIV medication, I mightn't notice any damage for for weeks or even months.

[wood]

No: What's coming out of the UK studies is that PrEP has to have the same adherence levels expected of someone with HIV. Percentage-wise that's in the high nineties, meaning you can really only afford to miss a dose a month. There is work going on to reduce the drug burden, with lower frequency drugs being a particular focus. My personal opinion is that after daily, the next logical step is weekly - every other day and it's too easy to wonder if it's a drug day or not. Adherence is always easier if it can be tied to another regular life event: I tie my antivirals to my diabetes medication. I know that if I don't take that I'm going to feel like shit, whereas if I miss a few doses of anti-HIV medication, I mightn't notice any damage for for weeks or even months.

I just set an alarm on my cellphone at a time when I am almost always certain to be up, and have the medication with me. Its never been an issue. I agree with what you are saying about adherence. For maximum protection it needs to be taken consistently at the same time. However remember, after the data was crunched from all US studies, they still found an over 90% protection rate from the equivalent of 4x a week, or every other day. Which does make sense. Remember PeP can be taken up 72 hours after exposure, although as we all know its better to take it ASAP. That being said, anyone who is on PrEP or thinking about it should make it a point to take it everyday at the same time. Why half ass it if you want the protection?