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Some comments about PrEP

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Every day I see on BarebackRT more and more guys on PrEP. Not sure if all are really on PrEP.

  1. If PrEP makes you bareback without worrying about HIV, what do you do about the other STDs?  I know that a few shots will fix it but still, no infections are good.
  2. When on PrEP, do you feel you have to have sex more often to justify taking the medications? Otherwise, why take PrEP sex is you are not having sex very often?
  3. What happens after PrEP? Or are you planning to be on PrEP for life?  It must be tough to be fucking freely on PrEP and then for some reason you have to stop, and you forget you stopped PrEP. You have to re-adjust to not being on PrEP.

Still trying to understand the furor that PrEP is causing.

 

 

 

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I've been thinking of some of these same exact things lately and since I started PrEP 2.5 years ago.  Everytime I go for the 3 month check up and get the stds checked.  I've had clamydia once a little over a year ago.  The next 3 visits, all stds were neg, and I was actually surprised......I've been having so much sex non-stop with other guys that I know are also fucking everyone in sight too, so I'm glad but honestly surprised each test.  

I did literally start feeling like I should have more sex to justify the real cost of the drug.  I figured out that it was about $43 per pill everyday when I started.  The accountant in me felt like I should be getting the insurance company's moneys worth if I'm taking such an expensive med lol.  Prob not the way the CDC wants you to look at it, but I've definitely been putting it to the test and getting my money's worth (and the ins company) :)

As far as being on it for life, time will tell......each time I'm approaching another age "bracket" I keep thinking my sex life is gonna drop off, (won't be in demand much), but the opposite has been happening - getting more and more young sluts into me the older I get it seems - daddy/boy thing if full mode and loving it!!

I also feel like almost every neg guy I know is on prep now (or says they are) and totally barebacking all the time - and wondering what happens if insurance decides to stop covering it.  I have company health insurance, but my copay is still 25% of the retail cost, then Gilead pays up to $3000 per year.  Well my $3000 ran out in October, so I coughed up $377 per month the last 3 month (not everyone can afford to do that and may skip it).  I'm 99% sure my plan is going to a copay of 35% of retail cost for 2017, which would mean a copay of $528 per month.   That $3000 will run out only 5-6 months into the year - then I'd have to cough up $528 per month for 6 months.  I know I won't do that, so haven't decided what I'm gonna do then.  I fucked raw for 10 years before PrEP so I know I'm not gonna stop bb for sure - may swing back to more topping "only", but def been loving being totally vers, flip fucking, swapping loads and being a whore in general, so I guess I'll figure it out in 6 months what path I'll take.  I used to hear talk of a quarterly shot instead of a daily pill.  So who knows what they'll come up with - I'll keep being a slut for the next 6 months till that Gilead money runs out and go from there.  

Sorry for all the boring numbers talk - now onto the sleazy fun part of this site, get myself horned up and start looking for some dick or ass for New Years Day :)

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^^ Not the greatest or easiest idea, but if you have two insurances or a friend with two, do double refills, preferably at different pharmacies that way you have extra. You can also go down to taking them 4-5 days a week. Any free/low income-gay clinics in your area?

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1 hour ago, topstud127 said:

^^ Not the greatest or easiest idea, but if you have two insurances or a friend with two, do double refills, preferably at different pharmacies that way you have extra. You can also go down to taking them 4-5 days a week. Any free/low income-gay clinics in your area?

This brings up the issue of abuse of insurance, the elephant in the room. Drug plans are great when all of a sudden you need to take an expensive medication because you're sick. Is it fair  for insurance companies to cover PrEP, which means that every other premium has to pay a little more to cover those on PrEP, many who just want to be the cumhole for the weekend at the local bathhouse?

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It's far cheaper for an insurance company to pay for PrEP for as long as your doctor prescribes it than for them to cover mandatory HIV meds for the rest of your life. Insurance companies know this that is why they cover PrEP. Even if you stay on it the rest of your life, it is still less medication than a person living with HIV needs. 

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On 1/1/2017 at 6:38 AM, hungry_hole said:
  • If PrEP makes you bareback without worrying about HIV, what do you do about the other STDs?  I know that a few shots will fix it but still, no infections are good.
  • When on PrEP, do you feel you have to have sex more often to justify taking the medications? Otherwise, why take PrEP sex is you are not having sex very often?
  • What happens after PrEP? Or are you planning to be on PrEP for life?  It must be tough to be fucking freely on PrEP and then for some reason you have to stop, and you forget you stopped PrEP. You have to re-adjust to not being on PrEP.

Taking them one-by-one:

1) For the other STIs, you get tested at least quarterly. Like colds and flu, STIs are a part of life, illnesses of social interactions. Unlike colds and flus, we have a level of shame and condemnation on STIs that just doesn't exist for other illnesses. Going in and getting tested four times a year is typically 4x more than most people go in and get tested. This helps to not only treat but to prevent the spread. I'm going to do monthly STI tests this year. I got an STI two quarters in a row. I'd feel better if I was never more than a month from knowing if something easily treatable is living inside me.

2) When I first started, I thought I needed to have a lot of sex to justify it. Now, I realize that's just as crazy as never having sex because I'm not on PrEP. There's no requirement for how much sex to have. I don't particularly care to get HIV. I do want cum flooding my ass every time I have sex. Whether I do that once a month or once an hour, I like the idea that I have the smallest chance possible of seroconverting.

3) One-pill-a-day won't be the only way to take PrEP forever. Right now, injectable PrEP is being studied. It'll probably be ready by the time Truvada comes off-patent in 2020. Also, the 2-2-1 model of dosing works almost as well as the daily dosing. I'm pretty sure we're going to have a time released Truvada (or the equivalent) in a few years. Take a whore pill an hour or two before you go get fucked and then not worry about things. That's going to be great, too.

Lastly, the goal of all of this is to greatly reduce the amount of infectious HIV out in the world. Since six-month undetectable people aren't infectious and since PrEP works 99+% of the time, there are multiple and overlapping strategies to break the prominence of HIV. I don't know if or when we'll completely eradicate HIV, but it's quite possible we can get to a place where the odds of anyone getting HIV is very remote.

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I'm a totally healthy person with zero other prescriptions (besides viagra I get from India - no insurance expense), so I went from being a very profitable "customer" to being a "guaranteed loss" for the insurance company just cuz I wanna be a whore.  Yeah, I'd be a bigger loss if I turned poz,  but the drug costs are kind of unsustainable.  How many guys in their 20s, perfectly healthy, are now guaranteed losses that "should be" profitable at that age?  Kind of a downer to talk about here, but realized from the time I started taking it I'm an automatic loss now, and a "net loss" on my small company insurance premiums.

I'm not low income so those kind of programs wouldn't help when I use up the Gilead copay assistance.  I "could" pay the extra amount for the rest of the year, but realistically I'd probably switch back to topping way more like I used to do to reduce risk, then pig out again in Jan 2018 again - if I have that kind of self control :)

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Hey guys,

I really love the thoughtful conversations here - and I thought, I'd just add a - let's say - european perspective here when it comes to the point of the costs of a PrEP.

Therefore I have to say that in my country isn't covered by the mandatory health insurance system. But I think it should be, like it is in France. Because in my perspective the system of insurance isn't about being "a loss" or a "profitable" customer - it is about covering risks by sharing them in a community. And being gay unfortunately rises the risk of getting HIV-positive. Being gay isn't something you choose to be. So I think it is only fair if the communitiy helps to cover that disadvantage. And besides that - imagine when HIV would be a major problem of heterosexual sex - do you think we would have that discussion? They'd spread the pills for free! ;O)

 

Just my two (Euro-)Cents. ;O)

Best wishes

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If now Truvada is taken by so many more people, why is the price that Gilead charges for it the same as before? The actual production cost is negligible (less than 10% of the price); the high cost of the pill is the result of depreciating all the R&D involved in discovering it and testing it and all the marketing and sales costs. If the expected demand now is much larger than it was before, such cost can be depreciated among more users. So the reason that insurance companies are losing money is because the price of the medicine has not dropped to reflect the higher demand.   Gilead investors according to the company's SEC filings have had already a cumulative return on investment of more than 600% over five years.  I don't feel guilty for getting out of the insurance company more in copays than my premium, but I think that the government and insurance companies have to start some day reining in on the cost of medications.

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A new drug costs about a billion dollars to develop, test, and gain regulatory approval. And only about one in twenty make it. Drug companies have to make back their investment. 

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5 hours ago, Ranger Rick said:

A new drug costs about a billion dollars to develop, test, and gain regulatory approval. And only about one in twenty make it. Drug companies have to make back their investment. 

That is the big lie the pharmaceutical companies tell. One of the two drugs  in Truvada was developed by the Institute of Science in Prague and the other at  Emory. Gilead did not fund the development of either drug. 

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8 hours ago, shyvers said:

If now Truvada is taken by so many more people, why is the price that Gilead charges for it the same as before? The actual production cost is negligible (less than 10% of the price); the high cost of the pill is the result of depreciating all the R&D involved in discovering it and testing it and all the marketing and sales costs. If the expected demand now is much larger than it was before, such cost can be depreciated among more users. So the reason that insurance companies are losing money is because the price of the medicine has not dropped to reflect the higher demand.   Gilead investors according to the company's SEC filings have had already a cumulative return on investment of more than 600% over five years.  I don't feel guilty for getting out of the insurance company more in copays than my premium, but I think that the government and insurance companies have to start some day reining in on the cost of medications.

 

Speaking of, its seems to be damn there omnipotent for gay men with insurance. All over the course of the last two years. Its time for the price to go down. $1400 for 30 days... Gilead card aside, I doubt they need to price it that high. When the time comes for generics, it'll drop, but until then, we're at their mercy. Meanwhile, they're testing other iterations so I'm guessing one will replace the other. 

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PrEP = Liberation.  Period.

So much of what we have been told about  "safe" sex has been in relation to 1) Pregnancy, 2) HIV, and 3) Getting other STDs.

1) doesn't apply (for most of us, sorry Heteros!)

2) doesn't apply to those on PrEP (or already Poz or don't care about HIV)  

3) Most STDs can be treated super easy.

I think the third part is hardest for those adjusting to a condom-free lifestyle.  There is still a stigma with STDs which is very mis-informed.  But the medical profession is coming around, as so many STDs can be easily taken care off with some pills.  Hep C?  well, that's another issue I'm trying to figure out.

So in short, no reason to be afraid of bareback.  In fact so many reasons to embrace it, and forget the BS we have been told about "safe" sex all these years.

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2 hours ago, EastBayRawVers said:

PrEP = Liberation.  Period.

Maybe in your case PrEP makes you feel free because all you care is protecting yourself from HIV. You decided to ignore Hep-C and Herpes and you feel that Chlamydia, Gonorrhea and Syphilis are not a big deal. But most people outside this Fetish/Fantasy world called "Breeding Zone" would have trouble understanding how could someone care so little about STDs. 

It's always better to avoid taking medications, especially these powerful medications found in PrEP. That's why my question #3, "What happens after PrEP?", is important. I recently went to a specialist who prescribed some medications for life and blood tests every 3 months to check my liver and kidneys, similar to PrEP. I said "Fuck you!" I found another solution to my problem. The question "For how long will I be on PrEP?" would be what I would ask myself.

The only sensible way to use PrEP is as a complement to another more sustainable strategy like Safestsex.org. I know that as a safestsex.org member I'm only reducing the risk of STDs because the information I get from other members is clear and includes all STDs. I can organize small orgies and meet other members at the local bathhouse reducing the risk, but I could not go to any sauna and take all cocks or fuck a hole that turns me on. As a member I can still have anon sex but then I have to be responsible and wait for the required time before I do my tests again. Only then I can meet with other safestsex.org members. But I run the risk of catching HIV, so PrEP can be of help.

A SafestSex.org member who takes a two-week "sexation" to Fort Lauderdale can go on PrEP a few days before until a few days after the holiday. This is what I mean using PrEP as a complement to a safestsex.org membership. But PrEP is used for a certain period of time, unlike the case of most guys on PrEP who have no idea when they'll stop.

Safestsex.org is not for everybody, just like PrEP.  I know PrEP let's slutty bottoms take anon loads without the fear of HIV, but I'm sure that something like safestsex.org may eventually evolve in my area to the point where you can actually have anon sex at a reduced risk. It's just a matter of people joining in and it could be possible.

Any other comments from guys on PrEP? How long will you be on PrEP?

 

 

 

 

 

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On 1/2/2017 at 11:14 AM, justsexnowatl said:

How many guys in their 20s, perfectly healthy, are now guaranteed losses that "should be" profitable at that age?  Kind of a downer to talk about here, but realized from the time I started taking it I'm an automatic loss now, and a "net loss" on my small company insurance premiums.

 

I've never been convinced that health care is supposed to be a for-profit / for-a-steep profit business. We have the ability to keep people happy, safe, and healthy -- be they gay, straight, bi, male, female, etc.  There's ways to modify, tweak, and otherwise manage costs and expenses. The overall idea that people are supposed to suffer in the interests of high profits just leaves me cold.

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