PrEP and high viral load

[bottom_gewillig]

I have talked to a poz top with a very high viral load, and he said „my VL is that high, that it can even infect someone who takes prep. Prep won‘t help you if i shoot my pozload in your ass“. Is that even possible? Is there a risk to get pozzed when you correctly take your prep but the top is highly toxic?

[Lily95]

it is very unlikely you will get hiv but there are some people with drug resistant hiv which can still infect you even if you are on prep. but for the most part that i have read most likely not. better to be safe than to risk though so I'd talk to a professional before doing anything risky

[viking8x6]

It is possible, especially if (as @Lily95 points out), their virus is resistant to the drugs in PrEP.

In practice, for people who are compliant with their PrEP dosing, the number of cases of it actually happening are less than 10, among all the hundreds of thousands (millions?) of people taking PrEP.

[rawboytoi]

I have been on PrEP for about a year and I take the medication consistently. I keep track of my med intake daily in an app. 

 

The other day I had receptive anal sex with another guy and at the end of the play he said something like "you are getting my babies", "you are getting knocked up" , etc. 

I don't know if he has a pozzing fetish. Assuming the worst case scenario that he truly has a high viral load how effective is PrEP against high viral load. I am on Descovy. Thanks. 

[viking8x6]

2 hours ago, rawboytoi said:

The other day I had receptive anal sex with another guy and at the end of the play he said something like "you are getting my babies", "you are getting knocked up" , etc. 

I don't know if he has a pozzing fetish. Assuming the worst case scenario that he truly has a high viral load how effective is PrEP against high viral load. I am on Descovy. Thanks. 

He might just have a breeding fetish. Or he might have a pozzing fetish but actually be negative or undetectable.

Someone asked almost the same question back in June, so I'm merging your topic with that. Read the above to get some answers to the HVL question (to the extent that there are any).

[BugchaserAmsterdam]

On 10/16/2023 at 11:36 AM, rawboytoi said:

I have been on PrEP for about a year and I take the medication consistently. I keep track of my med intake daily in an app. 

 

The other day I had receptive anal sex with another guy and at the end of the play he said something like "you are getting my babies", "you are getting knocked up" , etc. 

I don't know if he has a pozzing fetish. Assuming the worst case scenario that he truly has a high viral load how effective is PrEP against high viral load. I am on Descovy. Thanks. 

Which app do u use to keep track

[rawboytoi]

10 hours ago, BugchaserAmsterdam said:

Which app do u use to keep track

I use the Apple Health app. 

[PigFaggot2904]

On 6/17/2023 at 3:51 PM, viking8x6 said:

It is possible, especially if (as @Lily95 points out), their virus is resistant to the drugs in PrEP.

In practice, for people who are compliant with their PrEP dosing, the number of cases of it actually happening are less than 10, among all the hundreds of thousands (millions?) of people taking PrEP.

Key phrase is "compliant with their PrEP dosing".  I haven't looked, but surely there would be statistics where "inconsistent PrEP usage" played a role with infection.  

[HotLatinoAss]

No he is absolutely correct.  If someone has a very high virus load you can get infected.  There is also a PrEP resistant form of HIV but as someone said that is very rare.  I am a versatile/bottom and generally bottom for the men I am with and prefer to bottom bareback and take their loads, so I try to be with men who are negative and on PrEP, men who are poz and on TASP and men who are undetectable and get tested regularly.   At least in that way I know they are tested and know if their virus loads are uncontrollable or in the care of neg on PrEP know they are HIV neg.  Men who tell you they are neg but are not on PrEP POTENTIALLY are men who have not been tested for a long time if ever, so, they really have no idea what their status is.   If they are poz and untreated they run the risk of being the guys with very high virus loads which could be a real risk even for guys on PrEP.  I try to encourage any of my friends that are or aspire to be more sexually active and enjoy bareback play that they should get on PrEP to one, have the protection of PrEP and two, to get them to go get tested every three months.   Anyway there are plenty of hot guys out there for you to enjoy bareback so better to avoid higher risk situations versus being the one to test the limits of PrEP and have it fail to protect. 

[BootmanLA]

15 hours ago, HotLatinoAss said:

No he is absolutely correct.  If someone has a very high virus load you can get infected.

There's no evidence, to my knowledge, that a top having a high viral load can "break through" PrEP *assuming* the bottom is taking daily PrEP and hasn't missed any doses in at least a couple of weeks (and continues to take it after the sexual exposure). A high viral load may make it him more likely to infect a bottom not on PrEP than a top with a low viral load, but PrEP is remarkably effective.

15 hours ago, HotLatinoAss said:

There is also a PrEP resistant form of HIV but as someone said that is very rare.

Correct - to my knowledge, rare as this is, it's more common than getting infected by a HVL top if you're on PrEP and compliant with taking your medication daily. (I say "daily" because I don't know for certain that the "on demand" method is as effective with HVLs, but I am guessing that it is.

15 hours ago, HotLatinoAss said:

I try to encourage any of my friends that are or aspire to be more sexually active and enjoy bareback play that they should get on PrEP to one, have the protection of PrEP and two, to get them to go get tested every three months. 

Your profile doesn't say where you're from, but here in the United States, at least, prescribing PrEP is normally limited to 3 months at a time and isn't renewed without proof of a negative HIV test close to the renewal date - and ordinarily, that includes testing for other STIs as well. I'd hope regulations in other countries were similarly strict, but I know they aren't always.

15 hours ago, HotLatinoAss said:

Anyway there are plenty of hot guys out there for you to enjoy bareback so better to avoid higher risk situations versus being the one to test the limits of PrEP and have it fail to protect. 

Again - I'm unaware of any study showing that high viral levels can "break through" PrEP when it's consistently taken. Not any. If you are aware of such, please provide a link.

[viking8x6]

1 hour ago, BootmanLA said:

Your profile doesn't say where you're from, but here in the United States, at least, prescribing PrEP is normally limited to 3 months at a time and isn't renewed without proof of a negative HIV test close to the renewal date - and ordinarily, that includes testing for other STIs as well.

That's the recommendation from the CDC. In actual practice, things are nowhere near that regimented. At least not in my geopolitical area.

[amsrat]

9 hours ago, viking8x6 said:

That's the recommendation from the CDC. In actual practice, things are nowhere near that regimented. At least not in my geopolitical area.

That seems to agree with the experience of a friend of mine in SF, who can receive a month's sample on demand. To me that seems reckless, but it is what it is.

[RicardoFernandes]

That sounds very unlikely to me.

People with low viral load are very unlikely to infect you anyway, so the point of PrEP is to prevent infection when you have sex with someone who is infected and has high viral load.