Any PrEP tops become Poz?

[Guest NSAFUCKBUD]

Has anyone heard of a TOP who was taking PREP becoming positive?  It seems the greater concern and commentary is by bottoms.  I am curious to know if there are any TOPS on this site who take PREP to prevent against seroconversion?

[drscorpio]

On 7/19/2020 at 10:20 AM, Gympumper said:

Has anyone heard of a TOP who was taking PREP becoming positive?  It seems the greater concern and commentary is by bottoms.  I am curious to know if there are any TOPS on this site who take PREP to prevent against seroconversion?

Moderator’s Note: I split this post off from the PrEP Cumdumps thread because it seemed likely to get lost there. 

[bihairy]

On 7/19/2020 at 11:20 AM, Gympumper said:

Has anyone heard of a TOP who was taking PREP becoming positive?  It seems the greater concern and commentary is by bottoms.  I am curious to know if there are any TOPS on this site who take PREP to prevent against seroconversion?

Top on PReP.  Several years.  I don't even ask any more. Just fuck and cum inside.  Neg. so far.

[Guest NSAFUCKBUD]

Music to my ears . . .

[Speecar]

Haven't encountered that scenario. Vers top, neg, on a temporary prep hiatus, but was on for 5 years, no HIV issues. Dated 2 poz guys in that time, both also on meds, no issues. 

[BootmanLA]

Given the mechanics of gay sex and HIV infection, I'd imagine it's extremely difficult (ie close to impossible) for a top on PrEP to become HIV positive fucking a poz person, and if the bottom is undetectable, I'd say the odds are for all practical purposes zero.

With a detectable bottom, the odds would shift a bit. If a bottom has a high viral load, and the top fucks him roughly enough (or he's large enough) that the bottom bleeds, that opens a source of infection. And if the top has, say, any abrasion on his cock through which blood might enter, it's *possible* that even on PrEP he might get infected, but that's conjecture based on direct blood-to-blood transfer being potentially harder to stop. But that's a convoluted scenario that I think would seldom occur in real life.

[leatherpunk16]

1 hour ago, BootmanLA said:

Given the mechanics of gay sex and HIV infection, I'd imagine it's extremely difficult (ie close to impossible) for a top on PrEP to become HIV positive fucking a poz person, and if the bottom is undetectable, I'd say the odds are for all practical purposes zero.

With a detectable bottom, the odds would shift a bit. If a bottom has a high viral load, and the top fucks him roughly enough (or he's large enough) that the bottom bleeds, that opens a source of infection. And if the top has, say, any abrasion on his cock through which blood might enter, it's *possible* that even on PrEP he might get infected, but that's conjecture based on direct blood-to-blood transfer being potentially harder to stop. But that's a convoluted scenario that I think would seldom occur in real life.

I had a similar experience. In 2016, I went home with a guy after a leather contest, and we fucked. He bled all over my dick, and THEN told me that he is positive. The nice guy I came home with was very different once we got naked, and I was already not attracted to him. Looked different out in public, and yes I could see nor was I wearing the beer goggles. The blood freaked me out. He said was undetectable, but I didn't trust him, so I don't know. When Monday came, I called the clinic and said what happened in full detail. The receptionist said this was a non-exposure, and there's nothing to worry about. 

So yes, chances are super low and would require unusual circumstances to poz a top.

[bareback-flipflop]

I’m on Prep for two years. Only interruption was on spiring during the three month long quarantine period, which lasted without sex for me. As a full versa, fuck with many guys both as a top and bottom - only bb. I never ask status, but I know that I fucked with many poz-on-meds-guys. I have controls every third months and HIV infection has never been detected yet. 

[pussyboy82]

U=U

That's the term people use. Prep is the same stuff that keeps those diagnosed undetectable. 

I don't think there's an argument unless either party are not taking their medication responsibility. 

If one party isn't, you'd assume its the guy on prep obviously. 

[BootmanLA]

6 hours ago, pussyboy82 said:

U=U

That's the term people use. Prep is the same stuff that keeps those diagnosed undetectable. 

I don't think there's an argument unless either party are not taking their medication responsibility. 

If one party isn't, you'd assume its the guy on prep obviously. 

Mostly true. But:

a) PrEP and most HIV treatments *overlap* but are not "the same stuff". Virtually all treatment regimens, even the single pill ones, involve the two medications that are in PrEP and at least one, sometimes two, in addition.

b) You can have people who lie and say they're taking their treatment meds responsibly but they are not. You can also have guys who are just sloppy, missing doses. When I first when on treatment, I was manic about taking my pill every single day because my VL had been so high (and my t-cells so low) when I was diagnosed. As the numbers improved rapidly in just the first few months, for a while I got careless and sometimes planned to take the pill with lunch, but forgot it when I went out to eat, and then by the time I got back to work, it would have slipped my mind entirely. 

It took concerted diligence to train myself to bring my medication case with me everywhere I went, just in case pill time came around and I wasn't at home or at my desk. And I'm sure it can happen to others.