Poz Guy Against PrEP = A Guy Against Abortion? None of their business?

[rawTOP]

Today, on a gay webmaster board a poz guy started bashing PrEP. As I was responding to him it struck me that a poz guy talking trash about PrEP is pretty much the same as a guy talking trash about abortion - it's really none of their business. At one point he tried to say he knew what he was talking about because he took Truvada - to which I said, "So, if you take Viagra, does that mean you understand what it's like for a women to take Viagra?"

So do you guys agree with me? What do you think is an appropriate role for poz guys in the discussion of PrEP? Personally I think it's appropriate for them to make sure neg guys are aware of PrEP, and encourage neg guys to look into it, but I think that's where they should stop. And if they want to play a supportive role in marketing PrEP - I'm fine with that too. But, IMHO, neg guys should be out in front shaping the policy and opinions on PrEP.

Agree? Disagree?

Edited July 22, 2014 by rawTOP

[PissPigBrooklyn]

I think that it truly depends on why the person, poz, neg or not sure is speaking out against PrEP. He has a right to his opinion and a right to express it. What he does not have the right to do is to make up untrue facts about PrEP, judge or harass those who may be taking it or bully those trying to decide into taking a position which coincides with his. As you so rightfully point out, the best role a poz guy can play in dealing with PrEP is to make certain neg guys are aware of it (and also of PEP) encourage neg guys to consider, under the guidance of a medical professional whether or not it is a desirable measure for them and support their decision. It is what poz guys ask the rest of the world to do in dealing with their medications and choices. btw one of the earliest pioneers in AIDS treatment Dr. Joseph Sonnebend does not fully support PrEP as a substitute for other forms of HIV transmission protection. I disagree with him but cannot argue with his credentials.

[rawTOP]

I think that it truly depends on why the person, poz, neg or not sure is speaking out against PrEP. He has a right to his opinion and a right to express it.

See, I would disagree. Maybe it's because in undergrad and grad school I had some pretty strident feminists teach me that men really should have no voice in the discussion of abortion - it's not their bodies, hence it's none of their business. So right to you're opinion? Sure. But right to express it - not so much. I think they should stay out of the discussion.

What he does not have the right to do is to make up untrue facts about PrEP, judge or harass those who may be taking it or bully those trying to decide into taking a position which coincides with his.

I should probably explain that the guy I was arguing with was doing a "Well, PrEP may not actually be 99% effective like they say". It was a clear case of FUD (Fear, Uncertainty & Doubt) designed to make people think PrEP may not actually be all that effective. He was citing this article in the NY Times…

http://www.nytimes.com/2014/07/17/upshot/is-truvada-the-pill-to-prevent-hiv-99-percent-effective-dont-be-so-sure.html

Towards the end of the article they do state that whether it's 99% effective or 92% effective really doesn't make a difference from a public policy perspective. Which begs the question - why exactly did they title the article "Is Truvada 99% Effective? Don't Be So Sure…" I mean that's a total FUD way of wording it.

So it's not like he was making up untrue statements as much as ignorantly questioning the scientific and statistical conclusions in a way that made the general conclusions about PrEP sound questionable.

[wood]

Today, on a gay webmaster board a poz guy started bashing PrEP. As I was responding to him it struck me that a poz guy talking trash about PrEP is pretty much the same as a guy talking trash about abortion - it's really none of their business. At one point he tried to say he knew what he was talking about because he took Truvada - to which I said, "So, if you take Viagra, does that mean you understand what it's like for a women to take Viagra?"

So do you guys agree with me? What do you think is an appropriate role for poz guys in the discussion of PrEP? Personally I think it's appropriate for them to make sure neg guys are aware of PrEP, and encourage neg guys to look into it,

Agree? Disagree?

I agree fully. Its none of their business for one, but also I dont see why HIV+ guys are not interested in stopping the spread of HIV.

Really I dont understand outside of the realm of fantasy why anyone is really interested in spreading HIV. All it does is cause lifelong problems at best. We are NOT talking about raw sex here, I think most people desire to have condomless sex, Thats just a causal factor. HIV killed almost an entire generation of gay men, and even today remains an expensive and time consuming life long disease to deal with. Additionally despite what some on here like to profess HIV doesn't free ANYONE to do what they want sexually. Quite the contrary, if the person is open about their status it limits them, because people often do not want to sleep with an HIV+ person.

[bbzh]

As a poz guy, I have a right to my opinion about PrEP and I have a right to express it. It doesn't bother me at all if others don't agree with my position or my right to express it. Admittedly, I'm still rather new to the concept of PrEP. If it helps guys stay neg, great! I do think a neg guy should consider all points of view before making the jump. I don't really like this idea of trying to discredit or silence any critic of anything. I guess I'm a firm believer in the fact that truth (and science) eventually prevail. Trying to silence or discredit people reminds me of that trick in courtrooms when a hooker is put on the stand and her credibility is questioned because she's a hooker. Wait, hookers can't tell the truth?

Now here's what I am still trying to wrap my brain around. When I first pozzed several years ago, Truvada was one of the meds I was put on. Fast forward to 2014 - I ask myself, would I have been willing to have a frank and open discussion with a medical professional about having unsafe sex with multiple partners - hoping that he/she would tell me that there is this drug that poz people take that I can take and it will help me stay neg? That takes a lot of courage. Would I have been willing to try and get my insurance provider to pay for it? Or find another way to subsidize it? Besides, I thought the whole point of being neg was not having to take meds and behave as if I were poz. Hmmm. But that ain't my business though...

I really don't think this is a case of me being a "hater". What would I get out of hating? I am a healthy poz pig who had no side effects from the drugs I was put on. I pop my now one pill a day and get on with it. I let the neg guys worry about staying neg. I'm past all that dread of going to the clinic, worrying and waiting and wondering.

Now I do understand - somewhat - why there is such huge backlash from many gays about neg guys who are proudly saying they are on PrEP. It has to do with perception. And most people's perception of your sexual practices does (unfortunately) cause them to judge you. I'm even trying to look at this through a different lens. If a young woman goes on the pill so she can avoid severe cramping during her period, the pill is hailed as a miracle. But if people think that same young woman is going on the pill so she can fuck a zillion guys, guess what? She's a diseased whore, worthy of being looked down upon.

In a nutshell, I'd never discourage anyone from getting on PrEP. Hell, do you boo. But I think it's asking too much to expect others to cheer you on. At best PrEP is probably another tool for the toolkit to help you hopefully stay neg. I do think it's questionable to push it like it's 100% effective when that is being disputed. By the way, one of my best friends - who is neg - is in a long-term relationship with a poz guy and he started PrEP recently. Now I didn't get all up in his business as to why, but perhaps it's because they were having unsafe sex and he wants to stay neg. I hope for his sake that it works because I do care about him.

[fillmyholeftl]

I agree fully. Its none of their business for one, but also I dont see why HIV+ guys are not interested in stopping the spread of HIV.

Really I dont understand outside of the realm of fantasy why anyone is really interested in spreading HIV. All it does is cause lifelong problems at best. We are NOT talking about raw sex here, I think most people desire to have condomless sex, Thats just a causal factor. HIV killed almost an entire generation of gay men, and even today remains an expensive and time consuming life long disease to deal with. Additionally despite what some on here like to profess HIV doesn't free ANYONE to do what they want sexually. Quite the contrary, if the person is open about their status it limits them, because people often do not want to sleep with an HIV+ person.

Totally agree I offer my knowledge as a HIV Outreach counselor. If I can help educate someone, so they can make a better decision that's right for them...But opinions on its use.....ummmmm NO

[rawTOP]

I agree fully. Its none of their business for one, but also I dont see why HIV+ guys are not interested in stopping the spread of HIV.

The guy in question isn't wanting to see more HIV infections. It's more a case that's he's generally a bit bitter and always sees the glass half empty. I'm completely just speculating, but I'm guessing there's a little bitterness that he got pozzed before PrEP was available - so he's trying to find something wrong with PrEP - maybe that makes him feel better somehow. But if a lot of poz guys expressed the same opinion it would make neg guys less likely to see PrEP in the positive light it deserves. So him expressing his opinion (multiplied by the number of guys who feel like he does) ultimately leads to more infections, which is why I don't really think the nay sayers should be given platforms to express their FUD.

[wood]

The guy in question isn't wanting to see more HIV infections. It's more a case that's he's generally a bit bitter and always sees the glass half empty. I'm completely just speculating, but I'm guessing there's a little bitterness that he got pozzed before PrEP was available - so he's trying to find something wrong with PrEP - maybe that makes him feel better somehow. But if a lot of poz guys expressed the same opinion it would make neg guys less likely to see PrEP in the positive light it deserves. So him expressing his opinion (multiplied by the number of guys who feel like he does) ultimately leads to more infections, which is why I don't really think the nay sayers should be given platforms to express their FUD.

Ive ran into this a bit from some older HIV+ guys. Not many but a few seem really bitter about PrEP, like it should have been an option for them.

[wood]

As a poz guy, I have a right to my opinion about PrEP and I have a right to express it.

Now here's what I am still trying to wrap my brain around. When I first pozzed several years ago, Truvada was one of the meds I was put on. Fast forward to 2014 - I ask myself, would I have been willing to have a frank and open discussion with a medical professional about having unsafe sex with multiple partners - hoping that he/she would tell me that there is this drug that poz people take that I can take and it will help me stay neg? That takes a lot of courage. Would I have been willing to try and get my insurance provider to pay for it? Or find another way to subsidize it? Besides, I thought the whole point of being neg was not having to take meds and behave as if I were poz. Hmmm. But that ain't my business though...

I really don't think this is a case of me being a "hater". What would I get out of hating? I am a healthy poz pig who had no side effects from the drugs I was put on. I pop my now one pill a day and get on with it. I let the neg guys worry about staying neg. I'm past all that dread of going to the clinic, worrying and waiting and wondering.

Now I do understand - somewhat - why there is such huge backlash from many gays about neg guys who are proudly saying they are on PrEP. It has to do with perception. And most people's perception of your sexual practices does (unfortunately) cause them to judge you. I'm even trying to look at this through a different lens.

In a nutshell, I'd never discourage anyone from getting on PrEP. Hell, do you boo. But I think it's asking too much to expect others to cheer you on. At best PrEP is probably another tool for the toolkit to help you hopefully stay neg. I do think it's questionable to push it like it's 100% effective when that is being disputed.

Good reponse, and I get what you are saying.

On the note of healthcare, one of the big issues doctors face everyday is patients that lie. It is VERY difficult for a doctor to treat a patient correctly if they lie. While I get it may be a difficult conversation, all patients should be 100% truthful with their doctor. As far as the reason for taking it, the reason is NOT to stay off medication the reason is to avoid contracting a virus, and there is a huge difference there. Even the results in side effects of truvada in HIV+ vs HIV- people is VERY telling. HIV- people are showing much lower rates of side effects from the medication.

As far as cheering someone on, well the latest IprEX study results are in, and they actually did give 100% protection when taken correctly. Now with that said it is imperative people actually take it correctly for it to work.

As you stated it is another tool in the box. However if people are not going to use condoms, its the best tool out there.

[rawTOP]

As far as cheering someone on, well the latest IprEX study results are in, and they actually did give 100% protection when taken correctly. Now with that said it is imperative people actually take it correctly for it to work.

100% within the sample. Real world experience may vary slightly - that's why statisticians have "confidence intervals". Typically statisticians look at the range of numbers where they'd be 99% or 95% confident that the real-world results fall within that range. The bigger the sample size the smaller the confidence interval. In this case you'd choose the lower limit of one of those and that's the number you discuss publicly as the effectiveness of the treatment.

So even now you can't say "100% effective", but you can definitely say things like "at least as effective as condoms - probably more so". Which really is the message that needs to get out.

[wood]

100% within the sample. Real world experience may vary slightly - that's why statisticians have "confidence intervals". Typically statisticians look at the range of numbers where they'd be 99% or 95% confident that the real-world results fall within that range. The bigger the sample size the smaller the confidence interval. In this case you'd choose the lower limit of one of those and that's the number you discuss publicly as the effectiveness of the treatment.

So even now you can't say "100% effective", but you can definitely say things like "at least as effective as condoms - probably more so". Which really is the message that needs to get out.

Of course, I just simplified my statement because I didnt feel like typing all of that out.

[Guest JizzDumpWI]

Good discussion...

I am always troubled with 100% assertions, even though so far the record on Truvada is excellent. It is better than condoms taken regularly, and this latest study gives a good bit of leeway in what "regularly" means. Dozens of guys here and elsewhere have at least tacitly accused me of claiming 100% when I have never done that.

It is troubling that a few of our poz brothers seems to be anti prep, but no more so than neg brothers being anti prep. Best is to give the facts as we know them and realize we each need to make our own choice. I trust my doc on this far more than anything i read on the web... I do my best to counter anti-PrEP comments as do many poz guys here.

But, I fall in the camp that all voices can state their opinion (and realize the challenges that might ensue). I believe there is social risk by telling specific groups they should not have a voice. However it is equally valid to ask that those who oppose the science have their position challenged; and potentially be asked "what's in this for you?".

We see it here and elsewhere, the camp who appears to worship HIV and feel compelled to "defend" it vs. others who seek an end to its spread. Should not be a surprise though... We see the same thing with smallpox, polio...

The majority of poz guys I know support PrEP as much as us neggies support advances in HIV treatment. In fact some of PrEP's most vocal supporters on this site are poz.

[PissPigBrooklyn]

I do not consider strident feminists to be experts on a person's rights to express their opinion. I note there is very little criticism of men who express an opinion favoring right to choice so it would seem they are only in favor of suppressing one's voice when it disagrees with their own. I maintain that any poz person has a right, please note the word to express his opinion. Their situation should be evaluated by the listener as to the validity of their opinion. We still live in a country which guarantees free speech. This web site owes its existence to that right. As I said a person does not have the right to make up untrue facts about PrEP, to judge, harass or prevent a person for choosing the option of PrEP or PEP the same as any man does not have that option concerning abortion. Your evaluation that a poz man who is so stridently against the medications without cause is just plain irresponsible is well founded but what if a poz researcher truly found something disturbing about the treatments. (None has nor do I think one will) Would you say that researcher has no place in the debate? You are an intelligent man and I think you would say he has a right a duty even to report those findings. So I think it really comes down to responsibility and honesty. Any person who is willing to deal honestly and responsibly with the issue has a place in the debate. Those who do not deal in such a fashion should perhaps have their ideas and actions ignored. Thanks for letting me post.

[bbzh]

...As far as the reason for taking it, the reason is NOT to stay off medication the reason is to avoid contracting a virus, and there is a huge difference there...

I have a natural aversion to popping pills. I prefer to take them only when something is wrong with me with the hope that I can eventually stop taking the pill. I take HIV meds because I have a chronic condition that I need to control. Medication as a prevention tool - which is what PrEP is - is a foreign concept to me. Let's say a drug was found to be effective against prostate cancer. Would I seek it out and take it proactively even though as an African-American male I am at a higher risk for prostate cancer? I don't know. Maybe I should.

But first, neg guys have to be comfortable enough to initiate the discussion about PrEP with a doctor. Then there's the issue of medical professionals who may - because of their own beliefs about unsafe sex - not be supporters of PrEP who in turn use their position of authority to dissuade people. Let's face it, many people place a lot of weight on what doctors say. If your doctor says, no you are still at risk for contracting HIV, will you continue to shop for a doctor that tells you what you want to hear?

Now there are people who will always believe science over people. But anybody who has some knowledge about statistics and the darker side of academia knows how very easily statistics can be manipulated to support a particular point of view. It's really hard to know who to believe sometimes. I remember clearly one of my professors at Harvard telling us to be wary of academics who craft their message FIRST and then float the numbers that support their claims. I am just cynical enough to believe that some anti-gay group or someone else with deep pockets would sponsor some dodgy research and then plant information in the mainstream media for unsuspecting people to consume as truth. People have agendas that they are trying to push and are often ruthless when doing so. That's just the way it is. Taking aim at poz people who are detractors of PrEP is a nonstarter.

Just as an experiment, I recently told a guy who is into safe sex that I wanted to fuck raw and that I was on PrEP. He was not impressed at all. So, much work and education has to be done and this is going to be a long, drawn out campaign with lots of twists and and turns.

[VersatileBreeder]

Very interesting discussion. First, I'd like to say that I think all guys, neg or poz, should be able to voice their opinions about PrEP. An opinion is just that: an opinion. A former boss of mine always used to say, "opinions are like assholes... Everyone's got one." And it's very true.

Personally, I am very pro-PrEP. My only regret about PrEP is that by the time I realized I should be on it, my next test showed that I was poz and simply too late. I try not to harp on it, but I always wonder, "what if I had just started PrEP a few months earlier..." I have been noticing on BBRT in recent weeks that there seems to be a growing number of guys whose statuses are reading "Neg + PrEP." When I see that, I think to myself, "good for you man!" It actually brings me a bit of relief to see that. "Neg + PrEP" goes a lot further as a status listed on BBRT than simply "negative." We all know how that goes. Hell, trusting one of those "negative" guys is the reason why I am positive now.

I really can't understand why any guy, neg or poz, would be against PrEP. It is a means of drastically slowing the spread of HIV. Whether it is 99%, 92% or even if it were just 50% effective, it will slow down the spread of HIV. Guys are gonna bareback whether they are on it or not, just like how there are straight guys that are gonna fuck raw whether their girl is on the pill or not. The difference is if they are on PrEP, they have a greatly reduced chance of becoming infected. Condoms are tiring out in the gay world. Even guys who preach safe sex and regularly use them are gonna slip up time to time. And of course, there are going to be the guys like me who always use them and then just completely become desensitized to sex with them and give up on them completely. PrEP is the game changer we needed.

I read the NY Times article. For such a big news medium, I have to say I am quite shocked that this article was even allowed to be published, simply just based on how the information in the article seems to contradict itself over and over. I actually found it frustrating to read. I'm not sure how you guys read it, but to me, in a nutshell, this is what the article said:

"One-a-day pill for HIV prevention 99% effective? Don't be so sure. There were studies in which people took it and still became HIV+. Oh but wait, those people didn't take it regularly. In fact, the levels of Truvada in their blood indicated that they only took it about twice a week. Those who did take it everyday had showed no infections... Meaning for them, it was actually 100% effective! Those people were only 18% of the study, but it was still 100% effective for them! Researchers say that it may only be 92% effective, but that's only a statistical estimate. But even if it is 92% effective, combined with the low chance that someone would be infected anyway, it would be like a freak accident if a person on PrEP actually did get infected. OK, so to conclude, we just realized that we totally contradicted the point that the title of this article was trying to make and rather, proved that PrEP is actually an effective means of preventing HIV. We'll see ourselves out now."

Maybe CNN will be able to publish a better article if given the chance.