Prep and STIs

[Cutedelicategay]

We all know that Prep allows most to engage in bareback sex. With bareback comes STIs. How many times have you contracted  STIs after starting Prep and which ones? How do you deal with them? Do you think contracting STIs while on Prep increases the risk of Prep failure?

[BB4fking]

I got herpes years ago while still a consistent user of condoms. Since going on PrEP about 4 years ago I’ve had chlamydia and gonorrhoea dealt with in the usual way. Most recently I had syphilis and had a bad reaction for about 24 hours to the painful injection (flu like symptoms)  and my doctor has scheduled quarterly blood tests as specific follow up (separate to my normal blood/urine tests and throat/rectal swabs required with PrEP). Not sure I understand the question about ‘PrEP failure’ but I understand any failure to be rare and more usually to be linked to user failure to consistently take doses as recommended. 

[Cutedelicategay]

3 hours ago, BB4fking said:

I got herpes years ago while still a consistent user of condoms. Since going on PrEP about 4 years ago I’ve had chlamydia and gonorrhoea dealt with in the usual way. Most recently I had syphilis and had a bad reaction for about 24 hours to the painful injection (flu like symptoms)  and my doctor has scheduled quarterly blood tests as specific follow up (separate to my normal blood/urine tests and throat/rectal swabs required with PrEP). Not sure I understand the question about ‘PrEP failure’ but I understand any failure to be rare and more usually to be linked to user failure to consistently take doses as recommended. 

By Prep failure, I mean to say that if one catches STIs, what are the chances that Prep will fail? I keep reading and hearing that chances of HIV infection increases with STIs. But if this is the cause of Prep failure then Prep will be a sham.

[Guest Porthos]

Being poz already I'm obviously not on PrEP. Be that as it may I have noticed a huge increase in the number of guys who bareback and an increase in STI's...I've had syphilis twice and in almost 25 years of barebacking both instances were in the past 5 years .....PrEP and U=U has definitely led to the normalization of barebacking but also an increase in STI's...I now get tested every 90 days

[viking8x6]

Answered the survey for the numbers. As far as my scientific understanding allows (I have a PhD in science, but "medical science" is something of an oxymoron), STIs will increase the chance of PrEP failure, but your chances of HIV seroconversion with PrEP and an STI are still much less than with no STI and no PrEP. To put it bluntly, PrEP is not a sham by any means - it helps whether you have an STI (or a scratch, or other risk factors) or not, but it is not perfect.

As Mary Chapin Carpenter sings, "I Take My Chances" 🙂  Risk and death are both inevitable, so manage your risk to suit your preference.

Edited December 22, 2019 by viking8x6
clarification

[Cutedelicategay]

5 hours ago, viking8x6 said:

Answered the survey for the numbers. As far as my scientific understanding allows (I have a PhD in science, but "medical science" is something of an oxymoron), STIs will increase the chance of PrEP failure, but your chances of HIV seroconversion with PrEP and an STI are still much less than with no STI and no PrEP. To put it bluntly, PrEP is not a sham by any means - it helps whether you have an STI (or a scratch, or other risk factors) or not, but it is not perfect.

As Mary Chapin Carpenter sings, "I Take My Chances" 🙂  Risk and death are both inevitable, so manage your risk to suit your preference.

Unfortunately barebacking is back in sex given prep and u=u. However public nurses are of the opinion that undetectable with STI may increase VL above undetectable numbers. There should be a scientific study done regarding efficacy of Prep working when a prepster is infected by STI. That will prove whether Prep is nearly 99% effective or not as marketed and prescribed. If Prep reduces efficiency with STI and STI are norm due to Prep barebacking then Prep is really a sham at least in my opinion. 

[viking8x6]

10 hours ago, Cutedelicategay said:

barebacking is back in sex given prep and u=u.

True.

However public nurses are of the opinion that undetectable with STI may increase VL above undetectable numbers.

Nonsensical. "...increase VL above undetectable numbers" is a contradiction. I don't think that you said what you actually meant, but I am unsure what you did mean here.

There should be a scientific study done regarding efficacy of Prep working when a prepster is infected by STI.

Sure, but... All of the existing studies included patients who were infected with STIs, and demonstrated efficacy in the overall population.

If ... STI are norm due to Prep barebacking...

That's a big "if".  Several studies suggest that STIs are not significantly increased in a PrEP using population. See these links:

[think before following links] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00056-2/fulltext

[think before following links] https://www.cdc.gov/nchhstp/newsroom/2017/croi-prep-study.html

 

 

[viking8x6]

Another very relevant article on this subject:

[think before following links] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580999/

It is rather dense, but in summary points out a bunch of problems with the well-publicized meta-analysis study that drew the conclusion that rates of STIs were higher among PrEP users.

[tallslenderguy]

2 hours ago, viking8x6 said:

Another very relevant article on this subject:

[think before following links] [think before following links] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580999/

It is rather dense, but in summary points out a bunch of problems with the well-publicized meta-analysis study that drew the conclusion that rates of STIs were higher among PrEP users.

One could argue that being on PreP can reduce the spread of STI's because people of PreP get checked out more frequently.  Whether or not the regular check ups for HIV while on PreP include a complete screen for other STI's is questionable, but it is more likely that a caregiver is going to do a complete screen while you are there.  PreP therapy provides the opportunity for more frequent STI  screening. 

 

14 hours ago, Cutedelicategay said:

Unfortunately barebacking is back in sex given prep and u=u. However public nurses are of the opinion that undetectable with STI may increase VL above undetectable numbers. There should be a scientific study done regarding efficacy of Prep working when a prepster is infected by STI. That will prove whether Prep is nearly 99% effective or not as marketed and prescribed. If Prep reduces efficiency with STI and STI are norm due to Prep barebacking then Prep is really a sham at least in my opinion. 

Ditto viking's response.  The current scientific studies on PreP efficacy utilize guys having bareback sex, they don't ensure each partner the study participant is having sex with is clear of all other STI's besides HIV before having sex.

You may be referring to the possible synergy between herpes (HSV) and HIV.  There is study evidence demonstrating higher shedding in HSV infected upon initiation of ART.

"The study, “Increase in herpes simplex virus shedding at initiation of antiretroviral therapy (ART) and decrease in shedding over time on ART in HIV and HSV-2 infected persons,” was published in the journal AIDS" 

[think before following links] https://www.contagionlive.com/news/antiretroviral-therapy-initiation-leads-to-short-term-spike-in-viral-shedding-among-patients-with-hiv-and-hsv2-coinfection

 

[Slamuel]

Without the option to select ‘not caught anything’ this poll doesn’t give a true representation of the prevalence of STIs among prep users. 

[FelchingPisser]

1 hour ago, Herts said:

Without the option to select ‘not caught anything’ this poll doesn’t give a true representation of the prevalence of STIs among prep users. 

Or how long you been on PrEP.    Results are fairly worthless.

[Kimberley]

Before prep i never had contracted a STD before, i was picky with who i had baresex then, but that changed quickly when i started taking prep. there was no fear any longer to contract HIV so i started barebacking with anonymous men as a cumdump whore. no load refused and yeah that's become very quickly to a positive STD result with 3 STD's at the fist time ever in my life. since then it's on regulary basis that i contract STD's. chlamydia and gonorrhea every single time when i have been much active. i really don't bother any longer, that's part of the game when you are a bare cumdump whore