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Prep HIV and STIs


Cutedelicategay

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I keep on reading here and elsewhere that a lot of brothers are on Prep and as part of that process, go for regular testing which otherwise would have been procrastinated. In doing so, other STIS are caught on early and treated accordingly. 

As I understand Prep works very well, almost 99% barring a few cases of failure vice the number of guys on Prep. Prep use has been more so in order for guys to enjoy bareback sex. I keep reading that STIs are by products of barebacking. However I am confused that having other STIs increases chances of HIV infection even for guys on Prep. This is totally oxymoronic. The very intent of Prep is to avoid HIV infection from onset. 

Please enlighten us from your knowledge and experience. 

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On 12/20/2019 at 1:29 AM, Cutedelicategay said:

However I am confused that having other STIs increases chances of HIV infection even for guys on Prep. This is totally oxymoronic. The very intent of Prep is to avoid HIV infection from onset. 

Please enlighten us from your knowledge and experience. 

I'm not sure where you're reading this, but to my knowledge, it's false. I am unaware of any study showing that having another STI increases the odds of HIV infection for anyone, let alone people on PrEP. If you find such a claim, it would be interesting to see where this is being promulgated to see if they can back up this statement with any evidence whatsoever.

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3 minutes ago, BootmanLA said:

I'm not sure where you're reading this, but to my knowledge, it's false. I am unaware of any study showing that having another STI increases the odds of HIV infection for anyone, let alone people on PrEP. If you find such a claim, it would be interesting to see where this is being promulgated to see if they can back up this statement with any evidence whatsoever.

There is actually a ton of scientific data collected over the last few decades indicating that having an sit makes hiv infection more likely. Scientific studies have been conducted and verified by agencies such as the CDC and the AMA. Even a very basic google search will direct you to many empirical studies backing this up. here is just one of the hundreds of thousands of articles and studies written on the issue.

[think before following links] https://www.healthlinkbc.ca/health-topics/stdis

 

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27 minutes ago, BootmanLA said:

I am unaware of any study showing that having another STI increases the odds of HIV infection for anyone...

It has been conventional wisdom for quite some time that it does so, especially in the case where it actually causes ulceration (syphilis e.g.). Whether it is causative or merely correlative is less clear.  I did a bit of online research and found these pages informative:

[think before following links] https://www.cdc.gov/std/hiv/stdfact-std-hiv-detailed.htm

[think before following links] https://pubmed.ncbi.nlm.nih.gov/7848598/

 

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I am aware of the research and link between the increased risk of HIV when other STIs are involved. However if Prep is involved whether that link between increased risk of HIV in case of other STIs still exists is the question? If the risk exists then Prep strategy needs a rethink. Most guys take Prep to protect from HIV and bareback. This eventually increases the risk of acquiring other STIs.

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24 minutes ago, Cutedelicategay said:

However if Prep is involved whether that link between increased risk of HIV in case of other STIs still exists is the question?

I would expect that the proportional increase in the risk would be the same, but the base level of risk would still be enormously decreased by the PrEP. As @BootmanLA says, I don't know that there are any studies on it. Typically, the more different factors that can affect the measured outcome, the more difficult it is to get statistically significant results in that kind of study.

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This eventually increases the risk of acquiring other STIs.

That is a completely different issue from the one under discussion, or did you mean to say "...risk of acquiring HIV"?

Edited by viking8x6
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There can be so many angles to this. For instance, one could probably make a good argument that bareback fucking on PrEP increases the risk for contracting the common cold. In that case, it's not so much the type of contact or exposure as the fact of exposure close proximity exposure. Of course, i am being facetious to make a point, that each study needs to be examined to see exactly why the increase?  Is it correlative? Is it causative? Is it simply increased exposure? Is it weakened defense from fighting a battle on two fronts? etc, etc..  There are so many reasons that can factor into this kind of conclusion.

Not to mention how much of a risk increase is there? Is it a 10% risk? Is it a .00000000001 risk increase?  HIV transmission with meds is a good example of risk percentage. For example, though there is a still a considered  risk of contracting HIV from an infected person who is undetectable and on meds, the general consensus is now "undetecable=untrasmittable. 

When it comes to assertions about anything medical, my first question is: "based on what evidence?"  (not saying this to the OP, but speaking in general). Once the question is narrowed and the answer dependent on specifics, the conclusions often become clarified, and are rarely absolute. A popular inclusion in well performed studies is "further study is needed." 

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