Some comments about PrEP

[subbytch]

18 hours ago, topstud127 said:

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.

Truvada comes off patent in 2021. It's part of why there's such a push to develop injectables and reformulations. 

If the ACA were to survive -- it's not -- you'd have seen more downward pressure on Truvada's cost before 2021. We'll get to cheaper Truvada, it's just going to take a while.

 

12 hours ago, hungry_hole said:

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. 

Well, Hep-C isn't a big issue for HIV- people. There are some cases of transmission between negative people, but outside of injecting drugs or fisting, its really difficult to do. The best way to prevent Hep C transmission in negative people is to keep people that way.

Herpes is a risk, but herpes is a risk for everyone. It's a skin-to-skin transmitted disease. So you can wrap yourself from neck to knee in a plastic wrap, and still get it if you kiss a person. 

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It's always better to avoid taking medications, especially these powerful medications found in PrEP.

Truvada in HIV- people, is little stronger than aspirin. The majority of bodies have no problem tolerating it. And because of how well its tolerated in HIV+ bodies long term, if there was no other option ever coming down the pike, Truvada would still be a pretty good option for people.

But not everyone will be slutty across the days of their life. People change. People go through "seasons of risk" as Bob Grant says. So while some people will probably take PrEP (in whatever form) for decades, but others will go off and on it as needed.

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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.

Others will disagree, but I just can't see relying on data provided by someone else regarding STIs is a better policy than regular testing yourself. Taking PrEP, being checked at least quarterly -- if not more frequently -- is still the best way to make sure I'm not carrying around hitchhiker. Someone telling me they aren't, someone showing me a site or a printout, might reduce the odds a bit, but the only way to be certain is to be tested.

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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.

On demand PrEP, the 2:2:1 method, is a valid way of taking PrEP. It's not common Stateside because the testing was for daily PrEP. But the French have rolled it out, and there will be some longer term studies about if its already high level of protection is exactly the same as daily use. 

I've taken anti-depressants since I was 21. I'm 47 now. I expect to take some kind of anti-depressant and some kind of PrEP until I fall asleep for the final  time. 

[topstud127]

I'm 24 and I'm certainly a lost. I use my insurance for Truvada, anti-depressants, adderall, and all the associated visits and blood work. I'm still on my parents, but 1) the deductible is absurdly high so damn near everything is out of pocket. Its works better as a secondary supplement. 2) I don't want them in my business that way (HIPAA, but still).

All those things are more or less voluntary, but for better and worse, our medical system isn't built around "need." That said, if things weren't prohibitively expensive and insurance wasn't such a high profit business, I wouldn't be so indifferent to "paying my share." Instead, a month worth of pills is $1400 and the shrink I see every three months for five minutes to authorize my refills is $400 an hour with no insurance. 

[hungry_hole]

10 hours ago, subbytch said:

Others will disagree, but I just can't see relying on data provided by someone else regarding STIs is a better policy than regular testing yourself. Taking PrEP, being checked at least quarterly -- if not more frequently -- is still the best way to make sure I'm not carrying around hitchhiker. Someone telling me they aren't, someone showing me a site or a printout, might reduce the odds a bit, but the only way to be certain is to be tested.

I think this paragraph tells me that you don't understand the concept behind SafestSex.org because you say that the best policy is testing which is the fundamental part of the safestsex.org strategy: get tested, get tested, get tested.The only thing is that as a safestsex.org member you will be required to enter the specific details of each of the tests so then this information can be exchanged with other members and see when your potential fuck-buddy got tested for the different STDs.

It's true that guys on PrEP get tested frequently but guys who aren't on PrEP can also test frequently and if he's a member he can the enter the data from tests into his STD profile.

SafestSex.org membership has many "side effects" such as learning more about STDs and being aware of ways to prevent STDs. I also like it because it keeps track of my tests which I sometimes forget the dates. "It's been 8 months? I thought my last tests were done a couple of months ago".

SafestSex.org provides you with a tool to help prevent STDs. But it's up to you how you how to use the membership. Any members here? My SSXID is KUK777Q19 and I'd like to exchange with other members. You would have to tell me because a member won't see my data in their screen until I get to see the other member's data on my screen. Having my ID does not make my data public.

SafestSex.org is not a magic bullet that will make you immune to all STDs. I keep dreaming. I find myself sometimes with strong feelings to go to a bathhouse and have all kinds of sex with guys in the darkroom and in the gloryholes. Right now I could never have anon sex at a very low risk by knowing all guys are tested and as committed as I am to staying away from STDs. But I could see that it may be possible to have really slutty sex with not so much risk. It may possible.

[timfreo]

Mark my words. Prep should be banned. Totally. The virus will respond with mutations to circumvent it's effect, then Bam! Zombie Apocalypse!  

[subbytch]

14 minutes ago, timfreo said:

Mark my words. Prep should be banned. Totally. The virus will respond with mutations to circumvent it's effect, then Bam! Zombie Apocalypse!  

There's a fitness cost for HIV to mutate resistances. (It's happening now, before PrEP.) That cost makes it even less likely the virus can transmit and overcome a body's natural defenses. 

PrEP is not going to cause the apocalypse.

 

[Ranger Rick]

I've been on prep for about six months. It hasn't really changed my sexual behavior. Parr of me still doesn't trust it to be completely effective. 

I don't know how long I will stay with it. I am concerned about possible liver and kidney damage.

[MuscledHorse]

I'm going to address several things here from other comments, but first the IP's questions.

 

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.   

WHen you play any other sport--and sex is definitely a sport for the guys on here--you take on risks of injury great and small. Most STD's can be treated with antibiotics, though some are becomming more resistant to what we have available. Other's like herpes or HEP-C are treatable but not curable. I would hope that any HEP-C person would disclose themselves as such, at least until a HEP-C vaccine is finally perfected. BUt, like a twisted ankle or broken arm in football, these are the risks in out sport.

1. 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? 

No. I have a huge sex appetite and have a lot of sex anyway so nothing really changes there.

1. 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.

PrEP will go on for awhile but as new discoveries are made it's entirely possible that this process will be replaced in the future, such as if the HIV vaccine research going on finally is successful.

 

Now to address a few other points to the non-medical people above. HIV as a virus is a weak virus in actuality. THe key factor that makes it less virulent than other viruses is that during the replication process there is a "spell checker" that reviews the newly assembled RNA strand for accuracy against what it is supposed to be. HIV has no such "spell checker" and as a result many of its reproductions lead to nothing. That said, this same unchecked process could potential lead to a more virulent version of HIV, but even then, without a spell checker for the replication process its effects may be limited.

Given the number of patient I see that have diabetes, obesity, and/or cardiovascular disease and continue to just take medication because it is easier than actually fixing their diet and doing some exercise in spite of the mountain of studies that show how diet and exercise can reverse all those conditions, I have no trouble commencing PrEP so I can freely fuck like an animal.  

Also, the reason the price is so high is because we have no price controls in this country. The discount cards for you at patient level exist so you can still get the medicaiton cheaply but the drug maker can still bill the insurance at the inflated price they are charging.  Drug development has ZERO to do with drug pricing and everything to do with what the market will bear (much the same way for the insane cost tickets at Disney World). Drug development cost is a smoke screen the companies hide behind. As long as they are spending literally millions of dollars to advertise their drugs to the medically uneducated public on television they cannot use this defense and have it be credible; no one outside of medicine really needs the advertising (which is how it was for decades before DTC ads were made legal in the late 1990's.

 

[fvkmebb]

HEP-C is curable, not only treatable. But the medication is very expensive, and because there is now public health insurance in the USA, most of the US-americans can't get these pills. Most states in Europe will give you the healing within 6 month for nothing.

But in about ten years, the pills will be much cheaper ...

[Leather69]

My Hep C cleared spontaneously, after about 8 months. My specialist was waiting for the medication to come on our PBS scheme, but was keeping a major watch and could have got me on an access "trial". In Australia the medication now costs about $38 a script (waged) or $6 un-waged.. Our Govt is working to get it cleared from the population.