Risking it with an HVL top

[BellyAndBriefs]

So, I have been chatting on and off with this guy on sniffies for months. He's really hot and got a nice big dick and he's also a poz top (as well as bottom sometimes). We talked about the fantasy of him giving me his poz cock and cum plenty of times, but just today I message him wanting to fuck and he tells me he's been off meds for about two weeks and now he's toxic if I wanted his load. Of course I was excited to jump on that, but I hesitated. 

I've been taking prep every day with only one or two missed doses months ago for about a year now. I've had raw bareback sex with guys who I don't know their status or they're poz undetectable. My question is, after two weeks, if he is building up a high viral load, should that be an area of concern as still possibly pozzing me? I love the idea of taking poz loads but I am on prep for when I'm not horny and so I can live in my fantasy, so to speak. 

He said before that this wasn't his first time going off meds to give his gift to a bug chaser either. So, if he goes completely off meds once in awhile, does that mean that his hiv strain is becoming more resistant to meds and that my prep won't work? 

Are either or both of these contributing factors something I as a bareback bottom should be concerned with if I want to take loads while still staying neg on prep? I may convert fully someday and embrace my poz pig fantasies, but that can't be anytime soon while I have a partner to take care of, so I'd like to stay negative for now and just embrace my fantasies with only one pill for truvada a day. 

[timfreo]

1. Two weeks off meds and he is easily toxic enough to knock up a neg ass.

2. You're on Prep. He can't Poz you 

[BootmanLA]

7 hours ago, timfreo said:

1. Two weeks off meds and he is easily toxic enough to knock up a neg ass.

2. You're on Prep. He can't Poz you 

Mostly true. But the devil is in the details.

You're on PrEP - great. Assuming you've not missed any doses in the month before you have sex with him, you're almost certainly good to go. If you have missed doses, you may want to wait until you've had a month of steady dosing. Or - double dose on the day you plan to have sex, then make absolutely sure you take a dose 24 and 48 hours after the double dose, as though you were on 2-1-1 scheduling (and then resume the daily doses after that).

Secondly: PrEP-resistant HIV is rare, but it does exist. If you're really concerned about his med holidays having made his HIV PrEP-resistant, ask which med he was on before he stopped taking it, and compare the ingredients to what's in your PrEP prescription. If they're entirely different, it's probably not an issue (as any resistance would be to the meds he was taking, not yours). If there is overlap (PrEP typically contains 2 compounds, and most HIV treatments consist of three, sometimes four), then there's a small chance.

Mind you, the odds are still heavily in your favor that (as timfreo notes) he can't poz you.

[BellyAndBriefs]

2 minutes ago, BootmanLA said:

Mostly true. But the devil is in the details.

You're on PrEP - great. Assuming you've not missed any doses in the month before you have sex with him, you're almost certainly good to go. If you have missed doses, you may want to wait until you've had a month of steady dosing. Or - double dose on the day you plan to have sex, then make absolutely sure you take a dose 24 and 48 hours after the double dose, as though you were on 2-1-1 scheduling (and then resume the daily doses after that).

Secondly: PrEP-resistant HIV is rare, but it does exist. If you're really concerned about his med holidays having made his HIV PrEP-resistant, ask which med he was on before he stopped taking it, and compare the ingredients to what's in your PrEP prescription. If they're entirely different, it's probably not an issue (as any resistance would be to the meds he was taking, not yours). If there is overlap (PrEP typically contains 2 compounds, and most HIV treatments consist of three, sometimes four), then there's a small chance.

Mind you, the odds are still heavily in your favor that (as timfreo notes) he can't poz you.

Thank you for the informative answer. I'll have to ask him about that before we get it on.

[BellyAndBriefs]

On 9/10/2021 at 9:58 AM, BootmanLA said:

Mostly true. But the devil is in the details.

You're on PrEP - great. Assuming you've not missed any doses in the month before you have sex with him, you're almost certainly good to go. If you have missed doses, you may want to wait until you've had a month of steady dosing. Or - double dose on the day you plan to have sex, then make absolutely sure you take a dose 24 and 48 hours after the double dose, as though you were on 2-1-1 scheduling (and then resume the daily doses after that).

Secondly: PrEP-resistant HIV is rare, but it does exist. If you're really concerned about his med holidays having made his HIV PrEP-resistant, ask which med he was on before he stopped taking it, and compare the ingredients to what's in your PrEP prescription. If they're entirely different, it's probably not an issue (as any resistance would be to the meds he was taking, not yours). If there is overlap (PrEP typically contains 2 compounds, and most HIV treatments consist of three, sometimes four), then there's a small chance.

Mind you, the odds are still heavily in your favor that (as timfreo notes) he can't poz you.

So, I found out he was on biktarvy and has been taking a break since about 2 weeks before I made this post. I think that has one overlapping ingredient with what I'm on, descovy, but it has been some time since then so maybe the resistence has gone down if there was any? Note that I've taken my prep without missing any doses every day for several months. Should i double up doses to be sure? We may fuck this week.

[str8mature5]

If youron prep you shouldn't have an issue, but the choice is yoursif you double up your dose.

[viking8x6]

56 minutes ago, TonyBear said:

So, I found out he was on biktarvy and has been taking a break since about 2 weeks before I made this post. I think that has one overlapping ingredient with what I'm on, descovy...

IF the biktarvy kept him undetectable, then the three meds in it were effective (ie any resistance was not enough to keep it from working). The descovy gives you two of those three (yes, that's correct; let me know if you want details). I think it's very likely that simply by staying on the regular dose, you'd be completely protected.
 

On the other hand, IF the biktarvy DID NOT keep him undetectable, that would be evidence that his virus may have some resistance to one or more of the three meds in it, in which case you might want to think twice about taking his load.

[str8mature5]

36 minutes ago, viking8x6 said:

 

On the other hand, IF the biktarvy DID NOT keep him undetectable, that would be evidence that his virus may have some resistance to one or more of the three meds in it, in which case you might want to think twice about taking his load.

I stand corrected thanks for pointing  this out.

[BellyAndBriefs]

3 hours ago, viking8x6 said:

IF the biktarvy kept him undetectable, then the three meds in it were effective (ie any resistance was not enough to keep it from working). The descovy gives you two of those three (yes, that's correct; let me know if you want details). I think it's very likely that simply by staying on the regular dose, you'd be completely protected.
 

On the other hand, IF the biktarvy DID NOT keep him undetectable, that would be evidence that his virus may have some resistance to one or more of the three meds in it, in which case you might want to think twice about taking his load.

I just asked him and he said it kept him undetectable so everything should be fine. Thanks for the info!

[120DaysofSodom]

There is this misconception that people with high VL's can transmit a resistant strain to undetectable's. Whether you are undetectable or on PrEP, you are protected against his strain. He cannot infect you. Have asked this question to both my specialist and to my pharmacist. I can take all the high VL's I want and I am still protected against them because I am undetectable and I take my medication.

[120DaysofSodom]

On 9/10/2021 at 10:58 AM, BootmanLA said:

Mostly true. But the devil is in the details.

You're on PrEP - great. Assuming you've not missed any doses in the month before you have sex with him, you're almost certainly good to go. If you have missed doses, you may want to wait until you've had a month of steady dosing. Or - double dose on the day you plan to have sex, then make absolutely sure you take a dose 24 and 48 hours after the double dose, as though you were on 2-1-1 scheduling (and then resume the daily doses after that).

Secondly: PrEP-resistant HIV is rare, but it does exist. If you're really concerned about his med holidays having made his HIV PrEP-resistant, ask which med he was on before he stopped taking it, and compare the ingredients to what's in your PrEP prescription. If they're entirely different, it's probably not an issue (as any resistance would be to the meds he was taking, not yours). If there is overlap (PrEP typically contains 2 compounds, and most HIV treatments consist of three, sometimes four), then there's a small chance.

Mind you, the odds are still heavily in your favor that (as timfreo notes) he can't poz you.

You will only inherit (rarely) a drug resistant strain DURING the first, initial infection if you are unprotected, meaning you are not on PrEP or undetectable yourself. If you are undetectable, you are protected. If you're on PrEP, you are protected. The drug resistant strain wont transmit to you.

[BellyAndBriefs]

3 minutes ago, BaphometNocturne said:

There is this misconception that people with high VL's can transmit a resistant strain to undetectable's. Whether you are undetectable or on PrEP, you are protected against his strain. He cannot infect you. Have asked this question to both my specialist and to my pharmacist. I can take all the high VL's I want and I am still protected against them because I am undetectable and I take my medication.

This is a very reassuring answer. Thank you for this info.

[BootmanLA]

1 hour ago, BaphometNocturne said:

You will only inherit (rarely) a drug resistant strain DURING the first, initial infection if you are unprotected, meaning you are not on PrEP or undetectable yourself. If you are undetectable, you are protected. If you're on PrEP, you are protected. The drug resistant strain wont transmit to you.

That's simply not true. You're making the assumption that a drug-resistant strain will still be stopped by PrEP (or by being undetectable). The entire point about drug-resistant strains is that the drugs to which they're resistant won't affect that strain. That means, in turn: the person with that strain can't be treated with that drug, AND anyone who's taking a form of PrEP or being treated for HIV with medications that include that resistant drug is at potential risk for infection. That's not to say that such a person is going to infect everyone he has sex with. It's to say that protection is not completely assured.

PrEP is a powerful tool, but it's not an absolute, 100%, iron-clad guarantee against infection. It's pretty damned close, but if PrEP (in a particular case) consists of drugs A and B, and Joe has a strain of HIV that has become resistant to treatment by A and B, then that PrEP may not protect people with whom he has sex.

Mind you, there aren't very many strains of HIV that are drug resistant and even fewer that are resistant to more than one medication. That's why PrEP will continue to be effective for MOST people even in these cases, and why undetectable people (whose medications typically consist of at least three components) are even more likely to be protected from a super-infection. But blanket statements of "won't transmit to you" and the like don't belong in discussions of risk. 

1 hour ago, BaphometNocturne said:

There is this misconception that people with high VL's can transmit a resistant strain to undetectable's. Whether you are undetectable or on PrEP, you are protected against his strain. He cannot infect you. Have asked this question to both my specialist and to my pharmacist. I can take all the high VL's I want and I am still protected against them because I am undetectable and I take my medication.

I suspect what your specialist said and meant was that a guy who simply has a high VL can't harm you as long as you remain undetectable - which is, broadly speaking, true. It's not like him having a high VL is going to be too much for your treatment regime to fight off. But if that high VL is drug-resistant to one or more of the meds you're using in treatment, the calculus changes. It may be that the other drugs in your treatment regime (since there are typically 3 or 4 in each pill) will be sufficient to keep you undetectable even if one of the three is rendered ineffective because you've acquired a strain resistant to one of your meds. But that's not a guarantee.

What's keeping this from being a big problem, for now, is that drug-resistant strains are still relatively uncommon in this country. 

[120DaysofSodom]

2 hours ago, BootmanLA said:

That's simply not true. You're making the assumption that a drug-resistant strain will still be stopped by PrEP (or by being undetectable). The entire point about drug-resistant strains is that the drugs to which they're resistant won't affect that strain. That means, in turn: the person with that strain can't be treated with that drug, AND anyone who's taking a form of PrEP or being treated for HIV with medications that include that resistant drug is at potential risk for infection. That's not to say that such a person is going to infect everyone he has sex with. It's to say that protection is not completely assured.

PrEP is a powerful tool, but it's not an absolute, 100%, iron-clad guarantee against infection. It's pretty damned close, but if PrEP (in a particular case) consists of drugs A and B, and Joe has a strain of HIV that has become resistant to treatment by A and B, then that PrEP may not protect people with whom he has sex.

Mind you, there aren't very many strains of HIV that are drug resistant and even fewer that are resistant to more than one medication. That's why PrEP will continue to be effective for MOST people even in these cases, and why undetectable people (whose medications typically consist of at least three components) are even more likely to be protected from a super-infection. But blanket statements of "won't transmit to you" and the like don't belong in discussions of risk. 

I suspect what your specialist said and meant was that a guy who simply has a high VL can't harm you as long as you remain undetectable - which is, broadly speaking, true. It's not like him having a high VL is going to be too much for your treatment regime to fight off. But if that high VL is drug-resistant to one or more of the meds you're using in treatment, the calculus changes. It may be that the other drugs in your treatment regime (since there are typically 3 or 4 in each pill) will be sufficient to keep you undetectable even if one of the three is rendered ineffective because you've acquired a strain resistant to one of your meds. But that's not a guarantee.

What's keeping this from being a big problem, for now, is that drug-resistant strains are still relatively uncommon in this country. 

If you are protected, you are protected. It does not matter if that person has a rare strain that is resistant to those medications. That simply means that those medications dont work for them. It does not mean that he can transfer that strain to people that are protected because theyre on ARV's or on PrEP. Ill trust my specialist and the pharmacist that handles the clinics medications on this one. They went through years of schooling for this and have been treating patients with HIV for decades. What I said came straight from their mouths.

[chibtm2breed]

4 hours ago, BaphometNocturne said:

If you are protected, you are protected. It does not matter if that person has a rare strain that is resistant to those medications. That simply means that those medications dont work for them. It does not mean that he can transfer that strain to people that are protected because theyre on ARV's or on PrEP. Ill trust my specialist and the pharmacist that handles the clinics medications on this one. They went through years of schooling for this and have been treating patients with HIV for decades. What I said came straight from their mouths.

No that is NOT TRUE!!!! That is for SURE. BootmanLA is correct NOT what you think or did hear from your local Doctor. YOU really should google the scientific data for yourself. Although I think it's much more the case for a PrEP person with only 2 meds and I think re-infection with a stronger virus from what I've seen in studies is rare.

Edited October 19, 2021 by chibtm2breed