Should I go bareback and go on prep

[TarotAlex]

Should I go on prep and go bareback 

[BootmanLA]

13 minutes ago, TarotAlex said:

Should I go on prep and go bareback 

"Should" is a question only you can answer, and anyone else who responds here with either "yes" or "no" is not you and can't make that call.

Here are the basic facts, with which you can make that decision for yourself:

1. *IF* you want to remain HIV-negative, whether or not you decide to bareback, going on PrEP is a good idea, providing that you can adhere to taking the medication *every* *single* *day*. If you are the sort who forgets to take a dose of medication as directed, and you don't have some sort of way to force you to remember it (like a phone alarm reminder), then PrEP is probably not a good idea. In that case, if you want to remain HIV-negative, use condoms even if you also try to stay on PrEP. I assume you want to remain HIV-negative or you wouldn't be asking, but this is to clarify that if that if remaining negative is your goal, you have to commit to sticking with the medication.

2. Remember that PrEP, used alone, will only protect against HIV and not any other form of sexually transmitted infection (STI), such as syphilis, gonorrhea, herpes, and so forth. Those may also not be completely prevented by condoms, but they do offer at least some additional protection (at a cost of sensation, more for the top than the bottom, but still). 

That's basically all you need to make the decision for yourself, assuming that PrEP is readily accessible where you live.

[Guest]

8 hours ago, BootmanLA said:

1. *IF* you want to remain HIV-negative, whether or not you decide to bareback, going on PrEP is a good idea, providing that you can adhere to taking the medication *every* *single* *day*. If you are the sort who forgets to take a dose of medication as directed, and you don't have some sort of way to force you to remember it (like a phone alarm reminder), then PrEP is probably not a good idea. In that case, if you want to remain HIV-negative, use condoms even if you also try to stay on PrEP. I assume you want to remain HIV-negative or you wouldn't be asking, but this is to clarify that if that if remaining negative is your goal, you have to commit to sticking with the medication.

sigh.

Using prep intermediately is also a way to use PrEP.  Consult your physician or doctor about this.
You'd be taking the pills some hours before and after your sexual encounters.

Using PrEP daily is only one of the two options available. 

[Ctgaydave]

I've used condoms and gone bare and for me there is nothing like that feeling of cum leaking out of me and down my thighs... But it's entirely up to you

[Kimberley]

You have to make that decision for yourself. prep is most used as a free pass to bareback no doubt that. but you have to be aware prep isn't going protect you against STD's

[1hornyjohn]

Yes, you should 

[BootmanLA]

4 hours ago, BareLover666 said:

sigh.

Using prep intermediately is also a way to use PrEP.  Consult your physician or doctor about this.
You'd be taking the pills some hours before and after your sexual encounters.

Using PrEP daily is only one of the two options available. 

Except "intermediately" [sic] PrEP is not an approved use of PrEP and while apparently *largely* effective, it has neither been studied as extensively as daily PrEP nor is it as easy to manage.

For instance: it requires that the first, "double" dose be taken at least 2, but no more than 24, hours before sex. We all know of people who don't plan an hour ahead, much less 2. So if Johnny goes out and happens to meet Bob, and they're both horny and decide to get it on, chances are high they aren't going to wait 2 hours after Johnny takes his pills to get started. I have my doubts that in such a case, he's also going to remember the doses 24 and 48 hours after the sex (the timing of which is apparently considerably more important than daily PrEP because the level of medication in the system is not already at a protective level).

Some doctors may advise off-label use like this, but every one I've asked has said, point blank, take it every day. It's probably better than nothing, but unless PrEP is inordinately expensive for the individual, he's *always* better off following the standard, approved daily regimen. 

[Kimberley]

1 hour ago, BootmanLA said:

Except "intermediately" [sic] PrEP is not an approved use of PrEP and while apparently *largely* effective, it has neither been studied as extensively as daily PrEP nor is it as easy to manage.

AMprep from the GGD Amsterdam back in 2015 says otherwise. that studie was really clear about both methods work and all healthcares in The Netherlands follows the rules from GGD Amsterdam for prep useing

[BootmanLA]

4 hours ago, Kimberley said:

AMprep from the GGD Amsterdam back in 2015 says otherwise. that studie was really clear about both methods work and all healthcares in The Netherlands follows the rules from GGD Amsterdam for prep useing

Please re-read what I wrote. I did not say there were NO studies of on-demand PrEP. I said that it has not been studied AS EXTENSIVELY as daily PrEP - which has been subjected to an order of magnitude more trials and studies than "on demand". One "studie" [sic] does not mean that the two methods have been equally researched. I will also note that at least as of earlier this year, EVERY published study on "on-demand" PrEP only studied Truvada (and its generic equals), not Descovy (which is chemically different, and which is being prescribed in an increasing number of cases.

I noted on-demand is "largely effective". That doesn't change the fact that it's not AS effective as daily, most likely because it's harder to adhere to a regimen that isn't part of a set routine. It's easier to get into a routine of taking a pill every day with breakfast, or lunch, or whenever, than it is to figure out you're going to have sex later and start taking it then - and then remember what time you had the sex so you can time the 24-hour and 48-hour post-sex doses properly.

Let's face it: if a guy is kicking around his house on a Friday evening, bored with TV or whatever, and gets horny and decides to hit a bathhouse or sex club for some relief, he's not likely to take his pills and then sit and wait 2 hours before he goes off to have sex. Or if a buddy comes over on short notice and gets frisky, they're not likely to postpone sex for two hours while he waits for the pills he hurriedly swallowed to kick in. It's harder to manage - not impossible, but harder - and thus EVEN IF the two methods are equally effective, the fact that circumstances will likely render at least some "on demand" PrEP ineffective ought to be of concern.

Especially for someone who's worried about PrEP-resistant HIV. The way to avoid developing a strain of HIV that is PrEP resistant is to stay on a level of medication that prevents HIV from taking hold, period, such that someone doesn't end up accidentally pozzed via mistiming of limited doses, assuming he's negative, and continuing to "on demand" his infection into something that PrEP can't resist (if and when he infects another person).

[insatiable]

20 hours ago, TarotAlex said:

Should I go on prep and go bareback 

Should you go bareback?

In my opinion, YES!

 

Should you go on PrEP?

That's a personal decision.

Some of us have chosen to stop worrying and embrace the thrill of chasing bugs. But that's an individual choice, and we accept the positives and negatives that go with it.

Even if you go on PrEP, the medication will be more effective against certain strains and less effective against others.  PrEP also doesn't protect against STDs other than HIV.

You can talk to folks here individually, or with a doctor if you're really unsure.  You ultimately will need to decide on your own.

[Jimmi]

I think you need need to consult with a health professional. The other thing to think about is possible side effects of prep. If you have dodgy kidneys prep is not a good idea and if you’re pre-disposed to osteoporosis then you might want to think twice too. A good doctor/counsellor at a sexual health clinic  is going to be the best source of advice. 

[Kimberley]

8 hours ago, BootmanLA said:

It's easier to get into a routine of taking a pill every day with breakfast, or lunch, or whenever, than it is to figure out you're going to have sex later and start taking it then - and then remember what time you had the sex so you can time the 24-hour and 48-hour post-sex doses properly.

Routine isn't always a good thing. ive noticed by myself, i switched to swallow daily for 2 years now, but it has become so normal to not worry about HIV anymore combined with busy days i can forget to take prep that day. luckily most of the times i found out hours later that same day but it happens sometimes that i miss a dose. when i was taking prep on demand i never have forget a pill because it was more in my system how important it is after having baresex. but last 2 years i take daily loads 4 - 5 times a week from mostly a few men a day and don't bother about who is poz or not because it don't even mind because i'm protected can make you forget being protected isn't a standard thing

Edited August 19, 2021 by Kimberley

[PigBoyDallas]

Yes. You do want to check with your doctor to see how long you need to wait to bareback as Prep doesn't start working immediately…it takes time to build resistance. You need to make sure you adhere to taking your meds as directed too. I know guys who weren’t good about taking it regularly and wound up getting poz so don’t make that mistake.

[MuscledHorse]

I have been on PrEP since it came out. Thousands of cocks have spilled their seed in my ass. For me no greater high exists than a fellow male, purely for sport and pleasure has sodomized me and emptied his nuts in me, filling me with his warm male essence, knowing that some of it will absorb into me and his maleness and DNA will become a permanent part of my body. I say, go for it!

[fskn]

For people's information, intermittent or "2-1-1" PrEP has been recommended in France for years, following the successful IPERGAY trial, and it also appears in the pending update to the US CDC PrEP guidelines.

Data do not bear out worries about drug resistance. The components of Truvada and Descovy (more PrEP products are coming, including injectables that last a month or two; see the draft CDC guidelines) are also recommended as part of first-line HIV treatment regimens. Were resistance common, this would not be so.

Safety assessment/testing is part of the CDC guidelines. For example, for the small number of PrEP patients who encounter kidney problems when taking Truvada or Descovy, periodic testing will detect the problem.

Although PrEP does not protect against STIs other than HIV, CDC guidelines require medical professionals to provide quarterly STI testing to at-risk PrEP patients, including men who have sex with men. Often, this is a condition for refilling a 90-day PrEP prescription.

Given that many sexual infections are asymptomatic in men, frequent and routine (i.e., from a medical provider with whom you have an ongoing relationship, so you'll get your results and be able to return for treatment if necessary) STI testing makes PrEP users safer than non-PrEP users, who tend to test infrequently and rely on unfamiliar clinics (many clinic visitors never return for treatment). STIs in PrEP patients will be detected and treated quickly.

Most of all, it's important to discuss PrEP with, and receive comprehensive PrEP care from, a medical professional. (Depending on state practice guidelines, this need not be a doctor; in California, for example, PharmD's and other non-doctors can prescribe PrEP.) Intake testing; regular safety, HIV and STI testing; and support for adherence all matter. It's more than filling a prescription!