I Need Advice

[PozTopAtlanta]

I am a POZ have been since June 1987. Exclusively a topguy.

On meds and great numbers, yadda yadda. I normally only play with other POZ guys.

Normally, until 1 month ago when I met a tall dark and handsome submissive guy. I told him way before we met in person of my status, and I told him about PrEP. He told me that he had to check with his Doctor at the V.A. hospital.

We set up a playdate, I went to his place, where I fucked him AND did pull out to spew my load on his chocolate brown asscheeks. (2x)

Repeated our play session 2 weeks later, and again he told me that he had yet to hear from the Doctor.

We have another tentative playtime set up soon. I will not breed him until he is on PrEP for a full month.

My fear is that he has not and probably WILL not talk to his Doctor. What do I do? I have given my word that I will not breed him until he starts PrEP.

I fear that if I present an ultimatum, I lose a fuckbuddy, just as my dominant side is beginning to bloom.

HELP.

Edited May 14, 2015 by PozTopAtlanta

[evilqueerpig]

Unless you're willing to say fuck the PrEP and breed him, the ultimatum is necessary!

[Bttm2go]

Unless you're willing to say fuck the PrEP and breed him, the ultimatum is necessary!

Agree.

[TattPig]

Well, the one-month stipulation doesn't make any sense.

1. It doesn't take a month to build up a protective level of drugs. That happens from Day 1. He's not going to have any more protection on Day 30 than he has on Day 2.

2. PrEP and PEP are the same pill (Truvada). He can take Truvada even afterwards (72 hours) and probably be fine, so he certainly doesn't need to take them for a month.

3. Truvada stays in the bloodstream long enough in high enough concentrations to be effective even if you skip 2 days. The CDC is recommending "weekend holidays" for young people (haven't got results yet for more mature people).

4. If you're on meds and have great numbers ("undetectable"?), the chance of you passing it on to anyone are essentially 0 already. Hard numbers show that being on meds is better than using condoms.

 

You can certainly set your limits. I'm just suggesting that the ones you have set are not grounded in science or research.

Edited May 15, 2015 by TattPig

[PhilUrass]

It takes 7 days to build up a recommended level of Truvada for PrEP

PEP is usually drugs more than just Truvada, I believe.

Agreed - if you're undetectable, the chance of you infecting this guy is almost non-existent. I breed neg guys with no qualms, as long as they understand it's not 100% safe, but that it is a form of safer sex.

[HairyKink]

its not your job to manage his risk

[Eppigbtm]

http://www.cdc.gov/hiv/basics/prep.html

PrEP reaches full effectiveness in 7 days in rectal tissue, 20 days for full effectiveness in blood.
 

They clearly say take it everyday. No weekends off.

 

PrEP is different than PEP.

[bearbandit]

First question has to be what's your viral load? Last time I floated the idea that medical opinion is that you need at least VL 1k to be infectious, someone countered with the claim that there was a report of someone with a VL in the 380's infecting someone, but I con't remember if there was any concurrent infection such as syphilis, which does make infection easier. In the UK undetectable is between 70 and 20, depending on the lab the hospital uses and it's reckoned that an undetectable VL for 6+ months means you're not infectious (the reason being that HIV clears faster from blood than semen). I guess there's a possibility that integrase inhibitors might speed this time up, but that's personal conjecture based on the fact that integrase inhibitors get further into HIV's hiding places.

Depending on the nature of the submission, you could turn it into a game: I've made guys suck me off while wearing a condom "because you haven't earned my cum" - just a thought...

 

PhillUrass and Eppigbttm are right - it takes seven days for truvada to reach fully protective levels in rectal tissue, and twenty days for vaginal tissue (just throwing the info in there as it might be useful to someone). Guys taking truvada therapeutically are encouraged to maintain an adherence rate of 95% which equates to one missed dose of a daily pill per three weeks. Same for PrEP, though truvada does have an unusually long half life in the body hence the French(?) trial of "as and when" truvada. Personally, I feel uneasy about such dosing...

 

While it isn't your job to manage his risk for him, being poz too I understand your concern: on the occasions the diabetes lets me fuck, I won't cum in anyone if my VL is in triple figures, and it will have been discussed beforehand.

 

Truvada is often used as a component of PEP, and may be prescribed as PEP by itself if it's known that the top guy has a low viral load. If his viral load is unknown, then the usual prescription is identical to whatever the clinic regard as the best starting therapeutic prescription. Truvada is a good choice as the tenofovir component is pretty hard and fast on HIV and integrase inhibitors are gaining in favour as the third drug. As far as PEP is concerned, the sooner the better, emergency room in the middle of the night if necessary: the earlier PEP is started the more likely it is to succeed, The chances of success with PEP diminish with time, and I'm sure I remember a report saying that the success rate diminishes faster after 48 hours (I never did understand calculus).

[averageslut48]

You are not guilty.It is his decision completely.

[fukkmenow]

As long as you disclose your status the choice ultimately lands with him as to whether he's prepared to take your load or not.

My understanding, and please correct me if I have this wrong, but even precum can transmit the virus, to just the act of fucking him without cumming carries a risk.

However, there is also the personal aspect to this. It seems that you're not prepared to spunk up him without some degree of "protection" and that is your choice.

Ultimately you need to choose what is right for you as does he and if the two align fuck his brains out and if theybdontbyiubwikl need to accept your decisions without ultimatums or ifs & buts!

Edited June 8, 2015 by fukkmenow

[rawTOP]

The short version of what BearBandit said is that only one of you has to be on ARVs for there to be no risk of infection. Since you're on them you needn't worry so much as to whether he's on them.

[nekofox]

The thing to be careful about too is the fact that, as you mentioned, is that he's dealing with the VA, and there are still SO many instances where there are delays on getting anything straightforward at times with them.  I'd believe he is set for it, he's just waiting on an answer from them.