It Doesn’t Sleep

[viking8x6]

Sorry to hear your news, @ErosWired  A thought -

Because you're a poster child for compliance, it might be worth discussing with your clinician going on a non-premixed combination to find a second (or third) antiviral that's easier on the kidneys but still works against your strain. Clearly the one in Juluca isn't it, but there are at least half a dozen NRTI and NNRTI drugs that could be combined with the same integrase inhibitor in Biktarvy. You'd just have to take two pills a day instead of one. I know clinicians are worried that more pills will cause people not to do that... but that seems unlikely in your case.

 

[BootmanLA]

14 hours ago, ErosWired said:

This last check put my VL at 80. Detectable by two standards, Undetectable by the third. Untransmittable by demonstrated science. So, am I still safe, or an I not? Am I just less Undetectable? Does that mean Undetectable isn’t an absolute state? After all, you can’t be slightly pregnant or very dead - you either are, or you aren’t.

Understand I'm not a medical doctor nor an expert in viral levels, but my understanding about untransmittable is the same as yours: they determined that 'old' undetectable (200/ml) was untransmittable, and that what's changed is simply the level to which we can measure - so while you may not technically be "undetectable" any more, you're still in the safe zone for untransmittable.

I would also note that, given your particular proclivities about sexual activity, I'm not sure you'd pose a risk to a partner anyway, given how very hard/rare it is for a top to get infected from fucking a poz bottom. I'd say a top had a much greater chance of being infected if he were to fuck you after a poz top had done so, but that infection would be the result of the first guy's ejaculation, not you. And in fact that risk is there, obviously (to the extent it's a risk) whether you're detectable, undetectable, or negative.

[Poz50something]

On 10/18/2023 at 10:44 PM, ErosWired said:

In August my HIV doctor put me on a new medication which she said is just as effective as the one I’d been taking, but would not be as likely to damage my kidneys. She ordered a viral load test to see how it was doing, and I just got the result.

It did not do well.

Not only did my viral load jump, it quadrupled, to the highest level I’ve seen for nine years, since I was in the hospital with AIDS, and higher than on any other med I’ve taken. This tells me two things:

 

I don't blame you, as you have said, you are the poster child for compliance when it comes to taking meds. I do think, though, that doctors get 'paid' (encouraged, wined, dined, 69ed by pharmaceutical companies) to try out new drugs that suddenly become the darlings of antiretroviral advancement. I had this happen to me -  in 2015, when I was encouraged to change from 3 pills to one - Triumeq. About a month into taking the meds, my heart began to beat really fast as I was falling asleep. Had to change my HIV meds when hubs died in late 2017. Certainly grief wasn't any help, but I would be up 20 hours, sometimes 24 hours, for three days, and then crash and fall asleep for six hours. I went on the website, found out heart palpitations and cardiac arrest was one of the side effects of Triumeq. Changed meds to Genvoya - okay kidney damage ain't a 'fun' side effect, but my readings have been okay. Learnt my lesson really well.   

Edited October 22, 2023 by Poz50something

[mixnzz]

i've been on a few different ones over the years  started with atripla.....but my kidney numbers were showing signs of trouble....then switched to genvoya....from there to triumeg....now finally on juluca.....still through all i was undetectable

[ErosWired]

2 hours ago, mixnzz said:

i've been on a few different ones over the years  started with atripla.....but my kidney numbers were showing signs of trouble....then switched to genvoya....from there to triumeg....now finally on juluca.....still through all i was undetectable

I was started on Atripla - which was a royal pain in the ass because you have to time your meals around it - then Triumeq, which had lackluster performance for me, then Genvoya for a while, then Biktarvy for over three years until this failed attempt at Juluca. Now back to Biktarvy.

I had no sign of diabetes before I started HIV meds. The only person in my family who ever had it was a great-grandmother. I’m not obese. I eat a reasonable diet, don’t drink, don’t smoke, don’t use drugs. There’s no reason I should have diabetes. I firmly believe I’m experiencing it as a side effect. So, the price I have to pay for keeping this chronic, incurable disease in check…is another chronic disease that has to be kept in check because it’s potentially lethal.

Want to know what’s funny? The medicine I’m prescribed to keep the diabetes in check is known to possibly interact with the components of Biktarvy to cause damage to the kidneys. Hilarious.

All you dudes out there saying how much you just can’t wait to get pozzed, realize that, potentially, pozzed=diabetes. Pozzed=kidney damage. Pozzed=daily doses of harsh medication. Now, taking that equivalence, apply it to the sentence “I can’t wait to get pozzed.”

”I can’t wait to get diabetes.”

”I can’t wait to get kidney damage.”

”I can’t wait to get to take a dose of harsh medication every day.”

Is that what you’re saying? Because that’s what you’re saying.

[Poz50something]

1 hour ago, ErosWired said:

All you dudes out there saying how much you just can’t wait to get pozzed, realize that, potentially, pozzed=diabetes. Pozzed=kidney damage. Pozzed=daily doses of harsh medication. Now, taking that equivalence, apply it to the sentence “I can’t wait to get pozzed.”

”I can’t wait to get diabetes.”

”I can’t wait to get kidney damage.”

”I can’t wait to get to take a dose of harsh medication every day.”

Is that what you’re saying? Because that’s what you’re saying.

yeah, in a nutshell, seeing as HIV2 has been with us since 1984, that's what becoming poz entails. There are those not on meds who are aware, maybe not, that a body quickly loses the capacity to fight everyday pathogens, and I found that before, when the practice was to wait until the cd4s were dangerously low to start medications, that I was mostly exhausted doing simple chores. That's what signing up for HIV is. 

[lower_bucks_bottom]

For what it's worth; I was also taking Biktarvy and having kidney issues. My ID Dr switched me to Dovato and it kept me undetectable and fixed the kidney issues. YMMV

[dji101568]

I'm sorry to hear about the set-back with your meds and health - I hope things are going better and you're doing well.

[NWUSHorny]

Hearing all of this makes me realize how lucky I've been with this. The only ART I've ever been on is Triumeq, and while it has not been quite as effective at suppressing the viral load as my Dr would like, it stays in the 30-50 range and has only been below the 20 threshold twice, it 2as over a million when they started me on it. Other than while I was taking chemotherapy my CD4 count has stayed comfortably above 500 hundred, usually 850-900.  My CD4 count was at 550 when I simultaneously started Triumeq and chemo and while it did drop dangerously low for a few days when I was neutropenic and stayed around 200 for the duration of the cancer treatment, my CD4/CD8 ratio always stayed around 2 so they did not make any changes to my ART. I'm yet to have a blood test that indicated problems with kidney function, the only thing that has ever come up was a single test that showed slightly elevated liver enzymes about 2.5 years ago.

I hope that the rest of you can find a treatment that works and does not have serious side effects.

[Guest]

By what science is someone determined to be incapable of transmitting HIV? In my view, the only way to guarantee that is to be Neg.

[ErosWired]

33 minutes ago, Yorksub said:

By what science is someone determined to be incapable of transmitting HIV? In my view, the only way to guarantee that is to be Neg.

Your view is uninformed. Two major studies, called PARTNER-1 and PARTNER-2, conducted in 2008 and 2018 respectively, firmly established this. Here’s a link to the National Institutes of Health information on the topic:

[think before following links] https://pubmed.ncbi.nlm.nih.gov/31056293/

[echopork]

On 10/20/2023 at 6:30 AM, ErosWired said:

whether I can fuck someone without putting them at risk - which is a huge issue for me. Unless I’m Untransmittable, I do not, will not, fuck anyone ever again.

Then you should not fuck anyone ever again. Even if you reach the numbers (or lack of numbers) that render you untransmittable beyond doubt, those numbers are already outdated. They were good on the date the blood was tested. And you won't know again the next test. How can you be certain what they are on any date in between?

Personally, I think they more reasonable approach is to disclose status, and then it's up to the other party how they wish to proceed. They can use a condom. They can use PreP. They can use Pep. They can ask that we skip anal and only do JO/oral. They can pass on having sex altogether.

They have more options than ever before to protect themselves. Personal responsibility is a real thing.

[ErosWired]

9 hours ago, pig4darkfather said:

Then you should not fuck anyone ever again. Even if you reach the numbers (or lack of numbers) that render you untransmittable beyond doubt, those numbers are already outdated. They were good on the date the blood was tested. And you won't know again the next test. How can you be certain what they are on any date in between?

While it is true that viral load is constantly in flux, if one is rigorously meds-compliant - taking every dose prescribed - and reaches a point of durable Undetectability, there is no reason to anticipate the viral load rising to a transmissible level. I never miss a dose. Ever. At my last check, because of the med change, my viral load rose to 80, the highest level I have seen in nine years, and detectable by the >20 standard. Yet even so, it was still far below detectable by the >200 standard on which the PARTNER studies based their findings of untransmissability, and therefore even if I had let a Top take me in that state I would not have posed a danger.

I’m also tested at regular intervals. Your observation that a test result tells you only what is true before the test and provides no guarantee after is valid, but the implications are not the same in the situation of meds-compliant Undetectable HIV as they would be for, say, gono, chlamydia or syphilis. HIV viral load doesn’t skyrocket from UD to over 200 overnight in the presence of antiretrovirals - it can’t (med-resistsnt strains may be an exception). But I can test clean for a battery of STIs, take one load at a bathhouse, and come out a carrier for multiple illnesses.

That’s the risk that gives me the most ethical concern about serving as a cumdump. I can do everything possible to safeguard the health of the men who choose to use me, but in the end I am no more able to guarantee their safety from STIs than I am my own. Bareback fucking is a risky activity, and it cannot be made risk-free. When I raise my cunt up to be filled, I potentially raise it as a vessel to be filled with contagion for all who follow to dip into.

So yes, I do think very hard about never fucking anyone again, and eventually that argument will likely prevail in my head. In fact, if the day comes that I learn that I have sickened someone I am quite certain it will. But that decision will most probably be as a result of transmitting some other STI than HIV. For now, my duty to protect is at odds with my duty to serve, and I try to strike a balance between the two.

Yes, every man bears the burden of personal responsibility for his own protection. But those around him bear an equal responsibility not to put him in harm’s way or tempt him toward ill. What is my cunt if not temptation? It may be a temptation that brings him pleasure and relief, a fulfillment of his needs; but there is a chance it may be a temptation to harm, and neither of us can tell how those dice will land. We both have to weigh the risk, and the responsibility.

Edited December 4, 2023 by ErosWired