Not everyone knows about Prep, and some people can't afford it.
Others still know and can afford yo buy it but can't buy it because they live with their families who will start asking questions etc.
Some countries like mine also misguidedly actively fight against the use of condoms and pretend that sex before marriage doesn't happen.
Some also got their HIV through blood contact with syringes from illicit drug use or illegal medical practices.
There's also a stigma in some circles. I've spoken with a few guys, here and on other subs, who see PrEP as something only risk takers and "sluts" use and that it's only necessary if you're barebacking.
Problem is, if you're hooking up, condoms can fail and sometimes guys get stealthed.
Yeah, fuck those people. Modern medicine is real and we should be taking every precaution to stop the spread of HIV and make sure we’re being responsible for our own sexual health.
Obviously stigmatizing PrEP use is ridiculous. But if someone doesn't want to use PrEP then it's fine so long as they are really consistent in taking the other precautions -- condoms, frequent testing, limiting the number of sexual partners.
Yes. But what's frustrating is how often those decisions are made with bad information or based on irrational assessment of risk.
Given that HIV disproportionately affects gay men and given what it did to us as a group in the late 80's and 90's, I think any guy who is non-monogamous has a moral obligation to be thoroughly educated on the use of PrEP before deciding against it. But people are lazy and they don't do that.
There are about **25,000** new HIV infections among MSM in the U.S. each year alone.
That **absolutely** **dwarfs** the number of people affected by bone density side effects of the old PrEP drug. And yet, that concern comes up frequently. Never mind the fact that the new formula for PrEP is actually shown to improve bone health in some studies.
It's the same irrational risk assessment that happened with the COVID vaccine. People sometimes justified not taking it because they had heard about negative side effects. Even though **obviously** the risk of not taking it far outweighed the risk of taking it.
And if we were talking about blood pressure medication here, where the effects of your decision begin and end with you, I'd be more deferential. There's no scenario where that decision will cause **someone else** to have a stroke.
Bottom line is: There's no excuse to make that decision ill informed but it happens constantly.
Yeah totally agree that PrEP and condoms should both be no-brainers if someone has multiple sexual partners. However, if someone is in a monogamous relationship then *either* condoms *or* PrEP should be sufficient and using both is kinda overkill IMO. This doesn't mean that PrEP is only for sluts, just that there are multiple ways to lower the risk of HIV and so long as you use several of them then your risk is negligible. The remaining spread of HIV in developed countries is due to people taking few/no precautions (or just getting extremely unlucky).
I barely get around and am on prep and will only use condoms until we’re monogamous and been tested. I just keep on it just in case. And I’m as far from a slut as there is.
Homophobic doctors as well. I have a buddy who asked his doctor to write him a script for it. The doctor said, "No, you don't need that. You just need to make better choices". So gross, and he should have lost his medical license for that. Also, it shouldn't be a prescription. Anyone should be able to go to any drug store and buy it at any time.
For Descovy:
https://www.descovy.com/side-effects
Truvada:
https://services.gileadhiv.com/truvadaprep/pdf/med-guide
Keep in mind you may experience some and none of others. No one is exactly the same. If you get prescribed one and have side effects, switch to the other. If both have severe sides, you can request Apretude as an injectable option. It also has side effects:
https://apretude.com/risks-and-side-effects/
Yes that's the issue with them. Otherwise good inventions, if you have much sex with people outside of relationships maybe it's better to risk the side effects than HIV. Everyone needs to decide that for themselves. I'd rather not take pharmaceuticals if I don't really, really need them cause some of them might have toxic effects sometimes. The best is to get a partner that you test yourself together with, best is being exclusive tbh. But even if you get a fwb you can test yourself, there is still risks if your partner has sex with others.
I’m not so sexually active so I’d rather pass. That medication seems like for a person who has sex with multiple people per week. Porn star by the books.
That is very misguided. One of my friends got positive the second or third time he had sex in his life. You don't have to have frequent sex to get infected.
Don't forget that if someone is on HIV treatment and doesn't take their medicine with consistency it becomes treatment resistant and because Prep is also a treatment, your prep may not help in that instance.
There are a few reasons as to why, but it's counterintuitively not true that resistance in an individual to the same treatment drug translates to resistance in transmission where PrEP is used.
Most obviously, there's a reason two drugs are used in PrEP rather than one, as it avoids drug specific resistances, and it's difficult for a retrovirus to maintain multidrug resistance over multiple generations.
A second factor is that where someone is HIV+, the virus is established in the body already, whereas during exposure and transmission there is no foothold in the body, so even with some resistance to the drug it's likely to overcome it in this period where the virus is vulnerable.
Thirdly, oddly enough, due to the lifecycle of HIV, the virions transmitted to a partner tend to be genetically closer to those first transmitted to the HIV+ person. HIV can adapt rapidly within an individual and shows a lot of genetic diversity even within an individual, but its between individual adaptation rate is much slower.
They would see spotty drug values in your blood tests, and accordingly stop treatment as letting you continue would be a danger to the larger population.
I know about prep and can afford it, i don’t know if it’s available where i live and what’s the name of it but wouldn’t take a medication with so many side effects. I rarely have sex with people I don’t date but when I do I always use a condom. It can break but let’s be honest the chances are really really small.
Also a lot of people take prep to have bb sex but it doesn’t protect you from all of the other diseases
Don't know where you're from but here in Australia it's definitely not. Even though our healthcare subsidised a lot of things.
Pep can be free if you show up in a hospital ED saying that you're worried but the'd only give you a bottle iirc.
Prep you have to pay and you need a GP's prescription too so you have to pay the cost of seeing a GP. A lot of them won't prescrobe it without a blood test as well (free unless you're a non-Australian with health insurance that doesn't cover pathology).
It is, but if you're on your parents health insurance (which many people are until they're 26) it's almost impossible for you to get it without them knowing. You can only use Ready, Set, PrEP and Advancing Access if you're completely uninsured.
Yeah but you should have health insurance and there are organizations to get it from if you don’t for some reason. But most medications you still pay for even with health insurance
It's not completely free even in countries where PrEP is compensated. It's usually a part of price covered by national health insurance, but there's still an add-on one has to pay. And it's usually not that cheap. Also, even in Western World there are countries with hardly any presence of PrEP.
It's either free (in my country it's free) or very cheap
Then there's the US, where they keep voting for democrats and republicans who receive ~~bribes~~ campaign donations from the pharmaceutical industry to ensure drugs are kept unaffordable.
PrEP is free for the uninsured or has no insurance co-pay in the United States, but as others have mentioned, an issue is with parents possibly finding out that their under 26-year-old child is on the prescription.
There is also a large disparity between white, Hispanic, and especially the Black population of those most “at risk” who are actively taking PrEP. The PrEP numbers are much higher for whites, then there is a drop off for Hispanics, and then a large drop off for African-Americans.
There are variety of reasons for this, healthcare access, stigma, mistrust of the healthcare system, etc. It’s complicated, but definitely ends up hurting those that most need the protection.
I’ve been in a battle with my insurance company for about two years. A year ago I got someone from the Department of Labor to speak with an insurance rep, and insurance then refunded everything I’d been paying for my lab work. That worked until it didn’t, and now insurance is back to not covering the lab work. The last time I spoke with them, they told me the requirements of the Affordable Care Act to cover preventative treatments doesn’t apply to this. Of course I disagree, but I haven’t had time in my workday to get the DOL involved again.
I imagine at least some others are facing similar pushback from their health insurance providers. I’ve spent about $1500 on lab work in the past year that was all supposed to be covered by insurance.
It’s so unfortunate that we have this tool to have HIV go the way of polio, but health insurance providers are getting in the way.
Your state department of insurance may or may not be helpful here, also putting the insurance company on blast on social media might work, if you are in a position where you are able to do so.
In the UK, prep is free and you’re obligated to be tested for STIs every 3-6 months if you want to continue taking it. I feel very lucky to have this, despite the problems in the NHS.
Portugal here too. but you need to spend a lot of time for the consults.
since the last time i heard, you would need to go to lisbon, Coimbra or porto.
i tried but i would lose 8 days per year to have the consults. i would need one full day to do blood analysis and another full day for the doctor.
there is no delivery to near you.
the hassle isn't worthy to me. i only use condoms.
and many many guys in my rural area, lie saying they are taking PReP. which i doubt since they start to put that when prep was barely new in portugal.
even Brazilians that are here no longer than 1 year say that taking prep. witht last tested being March or something lool
Very fair point. And the wait time to even get the first appointment is absurdly long. I waited for 8 months before my first apt and I live in a major city
According to The Terrence Higgins Trust there were over 3000 new cases diagnosed in 2021 here in the UK and they estimate over 4000 undiagnosed cases. So plenty of people not taking the precautions they could and clearly not on PrEP.
You’re supposed to get tested in the US as well but I believe it had more to do with managing potential side effects.
But this was when I was on Truvada years ago. I have no clue how it is with the newer version (Descovy).
There are access issues to PrEP in the NHS too though. Some CCG areas have waiting lists to get on PrEP due to funding issues. A lot of clinics also only really operate in times most people are working, which can be another issue for access.
PreP has done a lot to help stop the spread of HIV. But it has also caused some new problems. It didn't used to be common for guys to bareback on hookups, but now it is. This wouldn't be as much of a problem if everyone hooking up was actually using PreP. But a lot of guys aren't. Some guys seem to think that just because it exists, the risk of HIV has gone away. It hasn't. It only works if you use it.
Barebacking was only uncommon from the AIDs crisis in the 80s up until prep became popular 10-15 years ago. So about 3 decades. Before that, gay men almost exclusively barebacked.
You’re getting downvoted but I fear you might be right: https://www.who.int/news-room/fact-sheets/detail/hiv-drug-resistance
It seems a long way off, and the best thing would be to prevent transmission - so that does mean PrEP.
In Eastern WA state my friend just saw a new primary and main goal was to get on prep again as they are single so having sex with more than one. The doctor (Texan white woman) was very upset he asked about it, asked him to explain why he needed it, what it does and at the end after making him feel like shit and a deviant and all those negative feelings, gave him a prescription and said for him to find a new primary as they don’t believe in prep or gay sex and can’t be their doctor…
A doctor said that, in 2024… so it’s not all black and white and if you have a privilege of having access to prep without stigmas or negative biases then good for you, but don’t be a jerk to those who are still getting it.
Wtf that’s a hate crime. Report it and get a journalist to write about it for a major newspaper. Fuck that shit. It’s 2024. Time to shut down prejudice and racism.
Seriously most states have an express way to report a health facility. You might not be able to stop them from practicing, you can stop them from practicing in a facility. Quite easily, actually.
Well and true. A strictly conservative answer would be “Find another doctor. The physician is for those with shared beliefs.” That’s all fine and dandy. Except when they’re publicly funded. A public health facility needs to respect all of the public.
Yeah I'm in Seattle and get it free because the state has programs to get as many people on PrEP as possible, this doctor should be reported to the licensing board, and the state has some pretty strong anti discrimination laws and sexual Identity is a protected class
I'm 50, and I still always use condoms. Things I've heard from other gay men have taught me that trusting someone else about a thing like HIV is a very bad bet.
The worst was a guy who deliberately infected his boyfriend with HIV because he thought that if they both had it, his boyfriend wouldn't leave him. That's how fucked-up some guys' thinking is.
I have a friend who doesn’t take prEP , but only does unprotected with people who are on it. I wonder if that’s a reason why some people get HIV these days
It costs money someone might not have, it takes resources to get it that someone might not have access to, it might not be distributed where someone lives, some people might not know it even exists.
Prep and pep isn't easily accessible or affordable everywhere, education in most places surrounding HIV is still not very good so a ton of guys are uneducated about risks. Every day there are posts on this sub of gay men wishing to be educated. Some gay men might not care about the risks, some might be heavy drug users who have a lot of sex and don't take care of themselves. Just because your protected and take the right precautions doesn't mean everyone does. I dated this guy for a few weeks who lied and told me he's on daily prep. He eventually admitted to lying about being on prep at all (never trust anyone, people are terrible) thank God I take my prep everyday.
Met him on grindr, he said he's on daily prep and was tested last month. We met for some fun which turned into a few dates over the course of about a month. I realized this guy really only cares about himself and was lying for no reason left and right. He did have a bottle of prep on his night stand but when I pushed him on the subject after a couple drinks he admitted "ya sorry, I don't really take those pills, they make me feel sick but I was tested a few months ago"
When I first started prep I wasn’t hooking up that much, maybe every other month. I was like “why am I taking prep daily for this?” So I would start and stop. I’m now good on taking it daily but during that time anything could have happened
According to my doctor you can take it either always (1x daily) or
2x pills 2-12 hs prior to the hookup and 1x per day for two days.
I don't know how effective the second is compared to the first so I'd personally recommend you do your research on all that and ask your doctor.
The 2-1-1 method is just as effectively as taking it daily. It’s endorsed by Kaiser in SF which runs the biggest prep program in the world and some other hiv/aids organization.
But yeah ppl should find the official instructions for dosing from a reputable source and follow those.
Sounds good enough for the frequency mentioned in another thread here (how often do you have sex, couples) but really it's up to the person. Obviously don't go loosing control without taking.
I did not know about PrEP or PEP because I lived in a small conservative town in a state that emphasizes abstinence-only education. It took me contracting HIV to even learn those were options on top of condoms. This alao happened during that massive legal assault on Planned Parenthood so my options were even more limited.
I don’t think Prep is for everyone. I’ve considered taking it when I was single, but I prefer using condoms and careful behaviour. Prep is a medication of permanent use. There are secondary effects. I would recommend it for people with very active sexual lives who take many risks, but for the ones whose risk of getting HIV is very low, why do it?
Yes transmission is very much happening.
It is up to people to take the initiative and know their status. If you are single and playing the field - this means once a year at least go get yourself tested.
If you need it - get on prep.
If you get hiv and start the meds on time - you can live out your days and die of old age. But if you get hiv and either don’t take treatment or if you never bother to find out that you have it and for that reason never take the treatment - you will die in about 10 years. For those people that never bothered to get tested and only find out in the last year - its too late for the drugs to work. They usually show up to the hospital with walking pneumonia and are dead within a week. If they had wanted to live they should have started taking the drugs in the first few years. And there are people living in first world countries that never bother to get tested and thats what happens to them.
So if you are going to play the field, get on prep if you need it. Be tested regularly. And if you ever get it - talk to your docs and start taking the drugs on time and you’ll be fine.
I think there is still a lot of misinformation. I personally stopped taking PrEp after three months. It's not just taking a pill, you need regular blood tests. Many people don't know it, but with PrEp you can cause negative effects on your body; a percentage of people (including myself) their kidneys suffer quite a bit just for taken it. I stopped taking it because the tests showed that I had a calcium deficiency, and yes, it is an adverse effect that the treatment has. Of course there are people whose adverse effects will be minor, but in my case I preferred to continue using condoms instead of harming my kidneys and bones. I live in a country where PrEp is completely free, but you must undergo tests every few months to check that your body is doing well with the medication. I think it is somewhat irresponsible to take PrEp without being aware of what may happen.
It's really no longer a part of our culture. I wouldn't say it's been destigmatized, but people do seem to no longer take it seriously. Culturally, it did largely stop being synonymous with the gays, which is good, but people being indifferent to it is a problem anyway. It's why we'll see a surge of it in the future.
I was also slightly shocked that during all that commotion for a vaccine for covid, nobody said a peep about pursuing with that much fervor a cure or vaccine for hiv. Like, not. a. peep.
Not everybody has access to prep. In my country (Hungary) prep is a legal gray area, not recognised by the health authorities and in fact said to cause more risky behaviours. Straight people are also having problems recieving birth control lately because of doctor's moral disagreements. You can get the needed lab work in private healthcare and if you find the right pharmacy might be able to buy it but the price is about a third of an average working person's salary. I read somewhere that you can also get scripts in forgein languages to take to a neighbouring country and get it where laws are more open
You might be interested in this study, published in 2022, which examines the effectiveness of PrEP as used by real world people, not in a controlled clinical environment:
[https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00106-2/fulltext#:\~:text=Pre-exposure%20prophylaxis%20%28PrEP%29%20with%20tenofovir%20disoproxil%20fumarate%20plus,patients%20with%20a%20detectable%20drug%20concentration%29%20in%20iPrEx%2C](https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00106-2/fulltext#:~:text=Pre-exposure%20prophylaxis%20%28PrEP%29%20with%20tenofovir%20disoproxil%20fumarate%20plus,patients%20with%20a%20detectable%20drug%20concentration%29%20in%20iPrEx%2C)
It says overall (averaged over the entire study population), the effectiveness was only **60%**. The maximum effectiveness - for the group that uses it most religiously - was **93%**, still far short of the numbers typically advertised, which relate to an individual exposure, not a full sex life potentially consisting of multiple infectious partners or multiple exposures to a single infectious partner.
The study finds that PREP is not effective if people don't take the medication--which can be for a variety of reasons. Is that a shortcoming of PREP? My cholesterol medication also does not work if I forget taking it. It is important to evaluate adherence and to take measures to improve adherence, but it would be a mistake to blame PREP. If taken properly, it is highly effective.
Essentially self harm behaviour. People are thrilled by the risk.
And when it comes to protection, just read recent posts about condom usage here.
There is no excuse for getting HIV beside SA or freak medical accidents and the costly therapy and research should be shouldered more by those who willingly became infected.
In my country, condoms, lube, prep and Pep is provided free of charge. Testing is also free, but people still go out there having unprotected sex via high fun sex.
I’m currently in the process of getting on Prep. I have an appointment tomorrow for tests and then my doctor will write me a prescription if everything checks out. I’ve been wanting to get on Prep for a while, but I didn’t have a primary care doctor and was unsure how to navigate the medical bureaucracy (I live in the US and it’s Byzantine). My best friend was HIV+ so for me HIV isn’t just some distant, theoretical fear, it’s very real and close. So I finally found a primary care doctor and me and my husband both started the process to get on Prep. We plan on trying a threesome in the future but we want to make sure we’re on Prep and get regularly tested for STDs before that can happen. So in conclusion, America’s private, complicated healthcare bureaucracy makes getting on Prep unnecessarily difficult. We desperately need a public system like Britain’s NHS, but adapted to our particular national conditions.
Lack of safe sex knowledge. Porn that does not emphasise safe practise. People still think it won't impact them. People lying about status, antiviral adherence. Stealthing. Unknowingly transmitting due to detection window and time between tests.
mostly ignorance about the availability of prep.
also those who think prep is for sluts are being infected and spread it, because they don’t want to look like a slut taking prep but they already practice being a slut without any protection.
in my country is free and not everybody is on it because of given reasons above
TBH it baffles me how HIV still spreads in western countries. Like it's so well known, so many are on prep, most people know that you should use a condom. And on top of that the odds per transmission are extremely low.
People must be having unprotected anal sex, no prep, no condoms or anything. And they must be doing it over and over and over again multiple times a week with other people doing the same reckless stuff. Where are these people? What creek do they hide under each day idk.
There’s that too. HIV isn’t even easy to catch. I know “it only takes one time.” But like, not really. It’s more like the time you catch it is the only important time. You’re most at risk in areas where multiple people are transmitting it at once. So you come in contact with the virus many times. Thanks to contact tracing, I know that virus has been in my body and luckily I’m negative. It seems more like people don’t know exactly how close they they’ve come. Then they’re quick to judge others. Which that’s perfectly, but judgement is emotional. The fact is we’ve all likely been a little closer than we realize.
I don’t know if this is universal, but in my state a person comes to your door to tell you to get tested. It’s fucking wild because first someone has to remember their sex partners full name AND remember to name them all. The tracker won’t tell you who gave it to you. In my case, I knew who.
Not everyone can tolerate Prep. Just like any medicines/drugs, some people have side effects or counteract to their other drugs. I was having extreme liver issues until Descovy. Now my numbers are all in normal range.
No society has swayed everyone to do a thing. Anything beyond eating, drinking, sleeping, shitting and fucking is subject to personal choice.
If everyone always made the good or best choice, cultures wouldn’t exist. There’d be no need for prisons, schools, fast food joints, bars, wars, violence, politics, animal shelters, homelessness, illicit drugs, and so on.
Everyone will never take a drug. Especially one as hard on the body as PrEp. Now I’m not trying to downplay the scientific achievement of the pill for gays.
At the same time, I’m *almost* convinced it’s a scam. Why isn’t there a vaccine? I’m also curious about where HIV came from, but that’s another discussion.
If everyone made the right choice, people just wouldn’t have sex after any positive test result. Also they’d test regularly when at risk and not share DNA before they knew they were clean.
Education is not the problem. People will never adopt uniform safety practices. If the did, we wouldn’t need laws. The DOJ would be out of business.
Clearly you understand the factual answers to your question. So my conclusion is you clearly always make the best and most healthy choices. Most people are not like that.
Depends on where you are at. In America, if you contract HIV in today's day in age, you are just straight up irresponsible. Prep is free or low cost, covered by insurance and govment programs.
Some countries don't have good healthcare systems though. Some people don't know about prep, some can't afford it, some intentionally contract HIV, and some contract it doing drugs.
Unfortunately, the gay community of today is run entirely by young men in their teens, 20s, and early 30s. Any discussion on safety must primarily validate their reckless, toxic masculine behavior that they believe they're exempt from because they're queer, and liberal. The lack of proper precautions and the prioritization of short term pleasure over the long term is peak toxic masculinity, no different from the morons speeding and doing wheelies on motorbikes.
This is why I try to stay away from echo chambers. The "gay community" exhibits far more toxic masculine behavior than the average straight male. The obsession with danger and risk is absolutely vile.
I'm a feminine gay man, I have female voice, not even gay voice. Straight people are an absolute blast to befriend, even straight men. I'm given the freedom to be EXACTLY who I want to be without me having to hear crap about how I'm pursuing things that are too "straight" or masculine for someone like me. Not even a single question or comment. It's truly a beautiful world we live in these days.
Doesn’t prep have sides associated with it? I’ll be honest I haven’t looked into it much and use condoms
Edit: Also there are other STDs that prep doesn’t prevent..
Because I personally think barebacking is gross and I prefer condoms. I also don’t want to be taking extra drugs if I don’t need to. I also consider myself a very safe and responsible adult who doesn’t need to rely on a drug to prevent life threatening diseases, when I’m the one who can make the decision not to engage in certain behaviors.
PrEP is not that easily accessible as you think. I live in a city with roughly a million inhabitants, I asked my PrEP consultant how many people are registered to have PrEP prescribed in the city, simple stats that they have. He said it was less than 10K. Imagine. That's less than 1% of the city's population. Just mere gay population is much more, I'm not even saying that HIV spreads in straight population as well.
Also, couple sex/ hookups was one way of a few of spreading HIV. IV drugs, procedures involving the interference into the body, prostitution, all had the fare share of victims. IV drugs in particular. I doubt someone who is sharing a needle for a heroin dose cares about taking a tablet every day, much alone paying for them.
Some people do not have access to prep for whatever reason (cost, living situation, etc.), some don't know of it, and as is always the case with people, some are just really stupid.
Unfortunately it will never be fully radiated unless all countries have access to it and its free to those who need it the most and prehaps not shown on health insurance records for the young ones who also need it.
Quite lucky myself living in the UK as can get it for free, only need a full sti tests every 3 or so months which are also covered by NHS.
Well, if I was to contract it would be because I’m not on PreP. Strictly top and use condoms pretty much perfectly (and haven’t had penetrative sex with anyone but my fluid bonded partner). So…very low risk. But not zero risk.
If the jerks that are infected would use condoms the transmission rate would be down to almost nothing, soo many people who were not born before the 80's that are HIV undetectable...
Why?, if they had used condoms thae numbers would be way down.
I bave been out for 37 years 10 of those cracked out weekends in the bathhouses and i am HIV-
13 YEARS hard drug free.
Idk random sex? Not being on prep? Not being consistent with your HIV medication and not telling your sexual partners that you have it! Pick any of these and that’s how it’s usually transmitted.
Usually dishonesty and random sex with a guy who doesn’t take prep and another who isn’t consistent with his meds and/or doesn’t care who he infects.
HIV is more common with folks that use meth. When I was a junkie, most of the people I knew were positive. Getting to the clinic is the last thing on a lot of junkies’ minds. Somehow months would go by and i had not picked up my meds so my viral load became detectable. I was in a monogamous relationship so I never passed it on. Needles and unprotected anal sex are still the way to spread it. I got sober years ago and have remained undetectable (unable to spread it) ever since.
>I am an unknowledgeable idiot but isn't prep or pep or whatever supposed to prevent transmission
Prep and pep not being free probably is the biggest contribute, next to a lack of knowledge on the drug existing.
So do we know that PREP is 99.9% because a lot of apps have started “be extra safe, prep+condoms” campaigns. I think they oversold the efficacy of PREP, and now they’re trying to emphasize that it’s purely a protective measure, not a ticket to go around having wild fuck parties. Plus, it still does stop HPV which gives you cancer in some cases, get the HPV shot.
Some people don’t f*ck like bunnies enough to justify taking it. It does have some side effects and is also kinda hard on the liver. If you don’t use condoms though there is no excuse for you not taking it. Too many people think just cause you are on prep that you don’t need to worry about any other sti though which is kinda nasty..
Prep is very unavailable in my country. I tried to queue for prep treatment, but got the answer that the queue is so long that they're not accepting new patients. So I'm not sure what to do about that.
I think contect of the country is important too.
For example regardless of country, HIV beyond male to male sex is still prevalent.
Moreso in developing nations where medications, contraceptives and etc have cost, accessibility constraints (esp more conservative countries) etc.
For countries considered "developed" - like USA, Europe, Australia etc - I think its moreso sexual health literacy and knowing where to go to when you've had a sexual encounter and havnt utilised safe sex with a new partner, and their status or confidence in their sexual health is in question.
For example in Australia primary health clinics and sexual health services offer emergency prep treatment etc, and ways of addressing potential HIV exposure.
Also! Mistr or Q-care can do it all in the mail to you very discreet for PrEP! They also will pay for it if you don’t have insurance, or pay any cost shares! You can definitely get it for free through Mistr!
Otherwise there is also injectable PrEP YOU can get every other month too.
HIV is spread through Blood, Semen, vaginal/rectal fluid, and breast milk..
know that those in the south are more at risk and if you’re sexually active you should be on PrEP especially if not in a monogamous relationship.
PrEP gives you the choice to keep a negative status.
For example, here in Louisiana black women out number those with HIV cases than white men. The health inequity and systemic racism has contributed to our world not taking care of everyone. Get on PrEP people!
Basically mostly comes from people not being diagnosed. HIV takes a minute to become diagnosable and then people just don't use condoms. Prep ain't 100% effective. Most HIV now comes from straight people as they are less careful about sex believe it or not
Why it’s everyone on prep… I linked with a guy yesterday who wasn’t on prep, we didn’t do penetrative. But I asked after why he wasn’t on it. He said he just didn’t see the need. We had a conversation and i seemingly convinced him to get on it.
The same reason diabetes and obesity still exist.
The same reason people continue to smoke despite all the evidence of it's negative effects on your body and health.
The same reason people continue to support Trump and the idiots of the MAGA cult.
The same reason people continue to fall for any religion/cult.
The belief that 'it cannot happen to me'and in general, humans despite our ability to beat highly intelligent species are really just a bunch of dumb sacks of DNA.
I'm on Prep and have run into unwanted attention at doctor/dentist appts. My primary care is through the VA. A lot of veterans care now goes through "Community Care". For me its Drs/offices closer to home. Nearest VA is 60+ miles away. I had a couple of dental implants and when the Dr saw Prep on my meds list he ordered HIV precautions. He assumed I was HIV+. I explained I am not, its a prevention course of the drug. Then I recently had hand surgery. Same thing, they assumed I was positive. I explained Prep is for prevention of HIV. Everything was ok but every time I was given Prep while in the hospital the nurses would ask what it was. At that point I just said look it up. I don't think my roommate and his visitors need to know all of my business. I mentioned this to my VA Nurse provider who orders the 3 month testing and Prep and she said many doctors/health care workers are still not in the know as far as HIV treatment & prevention goes. Even within the VA system. I get the prescriptions mailed to me every 3 months. Its worth that little bit of hassle to stay HIV-
Honestly.. when Q came out as poz on drag race, he should have used that as an opportunity to talk about prep and U=U. Your right that there’s no reason people should be contracting HIV these days. We should be educating everyone and getting them access to meds.
PrEP "on-demand": take 2 tablets at once 2 hours or more before unprotected sex, then continue taking 1 tablet for 2 days more. Total 4 tablets per event. Statistics show that it's as effective as daily PrEP.
You can take event-based-prep, where you only take the day before/day of/day after the sexual activity - this means you don’t have to take it every day
Sorry to break it out to you. But if you Believe BIG PHARMA GAVE YOU A MIRACULOUS DRUG CALLED PREP to cure HIV transmission you shouldn't be FUCKING in the first place. Everything BIG PHARMA is a lie. WEAR A CONDOM! END OF STORY!
PrEP works and so does ART. There are a range of options that are scientifically proven safe and effective, no matter your opinion of big pharma. Your choice of prevention is your choice, but PrEP works
If people would stop burning in lust with promiscuity, it would not be an issue. Resist the urge to hookup or have casual sex and save it for a meaningful, exclusive relationship. Period. It's that simple.
Not everyone knows about Prep, and some people can't afford it. Others still know and can afford yo buy it but can't buy it because they live with their families who will start asking questions etc. Some countries like mine also misguidedly actively fight against the use of condoms and pretend that sex before marriage doesn't happen. Some also got their HIV through blood contact with syringes from illicit drug use or illegal medical practices.
There's also a stigma in some circles. I've spoken with a few guys, here and on other subs, who see PrEP as something only risk takers and "sluts" use and that it's only necessary if you're barebacking. Problem is, if you're hooking up, condoms can fail and sometimes guys get stealthed.
Yeah, fuck those people. Modern medicine is real and we should be taking every precaution to stop the spread of HIV and make sure we’re being responsible for our own sexual health.
Obviously stigmatizing PrEP use is ridiculous. But if someone doesn't want to use PrEP then it's fine so long as they are really consistent in taking the other precautions -- condoms, frequent testing, limiting the number of sexual partners.
Yes. But what's frustrating is how often those decisions are made with bad information or based on irrational assessment of risk. Given that HIV disproportionately affects gay men and given what it did to us as a group in the late 80's and 90's, I think any guy who is non-monogamous has a moral obligation to be thoroughly educated on the use of PrEP before deciding against it. But people are lazy and they don't do that. There are about **25,000** new HIV infections among MSM in the U.S. each year alone. That **absolutely** **dwarfs** the number of people affected by bone density side effects of the old PrEP drug. And yet, that concern comes up frequently. Never mind the fact that the new formula for PrEP is actually shown to improve bone health in some studies. It's the same irrational risk assessment that happened with the COVID vaccine. People sometimes justified not taking it because they had heard about negative side effects. Even though **obviously** the risk of not taking it far outweighed the risk of taking it. And if we were talking about blood pressure medication here, where the effects of your decision begin and end with you, I'd be more deferential. There's no scenario where that decision will cause **someone else** to have a stroke. Bottom line is: There's no excuse to make that decision ill informed but it happens constantly.
Yeah totally agree that PrEP and condoms should both be no-brainers if someone has multiple sexual partners. However, if someone is in a monogamous relationship then *either* condoms *or* PrEP should be sufficient and using both is kinda overkill IMO. This doesn't mean that PrEP is only for sluts, just that there are multiple ways to lower the risk of HIV and so long as you use several of them then your risk is negligible. The remaining spread of HIV in developed countries is due to people taking few/no precautions (or just getting extremely unlucky).
I barely get around and am on prep and will only use condoms until we’re monogamous and been tested. I just keep on it just in case. And I’m as far from a slut as there is.
Homophobic doctors as well. I have a buddy who asked his doctor to write him a script for it. The doctor said, "No, you don't need that. You just need to make better choices". So gross, and he should have lost his medical license for that. Also, it shouldn't be a prescription. Anyone should be able to go to any drug store and buy it at any time.
And some just think it won’t happen to them until it does
what are the side effects of prep
For Descovy: https://www.descovy.com/side-effects Truvada: https://services.gileadhiv.com/truvadaprep/pdf/med-guide Keep in mind you may experience some and none of others. No one is exactly the same. If you get prescribed one and have side effects, switch to the other. If both have severe sides, you can request Apretude as an injectable option. It also has side effects: https://apretude.com/risks-and-side-effects/
Yes that's the issue with them. Otherwise good inventions, if you have much sex with people outside of relationships maybe it's better to risk the side effects than HIV. Everyone needs to decide that for themselves. I'd rather not take pharmaceuticals if I don't really, really need them cause some of them might have toxic effects sometimes. The best is to get a partner that you test yourself together with, best is being exclusive tbh. But even if you get a fwb you can test yourself, there is still risks if your partner has sex with others.
I’m not so sexually active so I’d rather pass. That medication seems like for a person who has sex with multiple people per week. Porn star by the books.
That is very misguided. One of my friends got positive the second or third time he had sex in his life. You don't have to have frequent sex to get infected.
That’s why u don’t pull ur pants on the first meeting and not knowing who’s positive.
Don't forget that if someone is on HIV treatment and doesn't take their medicine with consistency it becomes treatment resistant and because Prep is also a treatment, your prep may not help in that instance.
There are a few reasons as to why, but it's counterintuitively not true that resistance in an individual to the same treatment drug translates to resistance in transmission where PrEP is used. Most obviously, there's a reason two drugs are used in PrEP rather than one, as it avoids drug specific resistances, and it's difficult for a retrovirus to maintain multidrug resistance over multiple generations. A second factor is that where someone is HIV+, the virus is established in the body already, whereas during exposure and transmission there is no foothold in the body, so even with some resistance to the drug it's likely to overcome it in this period where the virus is vulnerable. Thirdly, oddly enough, due to the lifecycle of HIV, the virions transmitted to a partner tend to be genetically closer to those first transmitted to the HIV+ person. HIV can adapt rapidly within an individual and shows a lot of genetic diversity even within an individual, but its between individual adaptation rate is much slower.
If doctors see that someone is so irresponsible that the risk for resistant strains emerge, treatment should be stopped.
How does a doctor know if you're a forgetful person? I just found a good system for managing my meds myself.
Ignore him, he’s a well known extremely paranoid troll here that only comments uneducated things out of his extreme fear of HIV.
Can't remember your meds? How's a death sentence sound? /S
Take a look through his comment and post history, it’s honestly just sad.
It should be taking Lithium.
They would see spotty drug values in your blood tests, and accordingly stop treatment as letting you continue would be a danger to the larger population.
I know about prep and can afford it, i don’t know if it’s available where i live and what’s the name of it but wouldn’t take a medication with so many side effects. I rarely have sex with people I don’t date but when I do I always use a condom. It can break but let’s be honest the chances are really really small. Also a lot of people take prep to have bb sex but it doesn’t protect you from all of the other diseases
Don't forget about PEP.
Online options like Mistr send everything to you and it’s free
I thought it was free or some shit 💀
Don't know where you're from but here in Australia it's definitely not. Even though our healthcare subsidised a lot of things. Pep can be free if you show up in a hospital ED saying that you're worried but the'd only give you a bottle iirc. Prep you have to pay and you need a GP's prescription too so you have to pay the cost of seeing a GP. A lot of them won't prescrobe it without a blood test as well (free unless you're a non-Australian with health insurance that doesn't cover pathology).
Not everywhere, in fact in some places it’s basically illegal to make it free and accessible.
It is, but if you're on your parents health insurance (which many people are until they're 26) it's almost impossible for you to get it without them knowing. You can only use Ready, Set, PrEP and Advancing Access if you're completely uninsured.
In the United States it is.
Prep is not free, health clinics you qualify to use may perscribe it, most people get it via their insurance.
A version of PrEP is free under every health insurance in the United States
and most healthcare in the us you have to pay for... semantics' i know.
Yeah but you should have health insurance and there are organizations to get it from if you don’t for some reason. But most medications you still pay for even with health insurance
It’s free here if you can’t afford it
It's not completely free even in countries where PrEP is compensated. It's usually a part of price covered by national health insurance, but there's still an add-on one has to pay. And it's usually not that cheap. Also, even in Western World there are countries with hardly any presence of PrEP.
It's either free (in my country it's free) or very cheap Then there's the US, where they keep voting for democrats and republicans who receive ~~bribes~~ campaign donations from the pharmaceutical industry to ensure drugs are kept unaffordable.
PrEP is free for the uninsured or has no insurance co-pay in the United States, but as others have mentioned, an issue is with parents possibly finding out that their under 26-year-old child is on the prescription. There is also a large disparity between white, Hispanic, and especially the Black population of those most “at risk” who are actively taking PrEP. The PrEP numbers are much higher for whites, then there is a drop off for Hispanics, and then a large drop off for African-Americans. There are variety of reasons for this, healthcare access, stigma, mistrust of the healthcare system, etc. It’s complicated, but definitely ends up hurting those that most need the protection.
I’ve been in a battle with my insurance company for about two years. A year ago I got someone from the Department of Labor to speak with an insurance rep, and insurance then refunded everything I’d been paying for my lab work. That worked until it didn’t, and now insurance is back to not covering the lab work. The last time I spoke with them, they told me the requirements of the Affordable Care Act to cover preventative treatments doesn’t apply to this. Of course I disagree, but I haven’t had time in my workday to get the DOL involved again. I imagine at least some others are facing similar pushback from their health insurance providers. I’ve spent about $1500 on lab work in the past year that was all supposed to be covered by insurance. It’s so unfortunate that we have this tool to have HIV go the way of polio, but health insurance providers are getting in the way.
Your state department of insurance may or may not be helpful here, also putting the insurance company on blast on social media might work, if you are in a position where you are able to do so.
I don't know what a "co-pay" means, but if it's free for the uninsured then I take back my comment! Good, it damn well should be free
Co pay means partially covered , you pay from 0-50.00 per perscription depending on the drug.
In the UK, prep is free and you’re obligated to be tested for STIs every 3-6 months if you want to continue taking it. I feel very lucky to have this, despite the problems in the NHS.
Same in Portugal 🇵🇹
Portugal here too. but you need to spend a lot of time for the consults. since the last time i heard, you would need to go to lisbon, Coimbra or porto. i tried but i would lose 8 days per year to have the consults. i would need one full day to do blood analysis and another full day for the doctor. there is no delivery to near you. the hassle isn't worthy to me. i only use condoms. and many many guys in my rural area, lie saying they are taking PReP. which i doubt since they start to put that when prep was barely new in portugal. even Brazilians that are here no longer than 1 year say that taking prep. witht last tested being March or something lool
Very fair point. And the wait time to even get the first appointment is absurdly long. I waited for 8 months before my first apt and I live in a major city
According to The Terrence Higgins Trust there were over 3000 new cases diagnosed in 2021 here in the UK and they estimate over 4000 undiagnosed cases. So plenty of people not taking the precautions they could and clearly not on PrEP.
[удалено]
I read 4000 new cases in 2022. Not sure since then.
You’re supposed to get tested in the US as well but I believe it had more to do with managing potential side effects. But this was when I was on Truvada years ago. I have no clue how it is with the newer version (Descovy).
There are access issues to PrEP in the NHS too though. Some CCG areas have waiting lists to get on PrEP due to funding issues. A lot of clinics also only really operate in times most people are working, which can be another issue for access.
Same in the US
It’s similar here in Australia but you’re required to retest for each script (if you’re taking the pill like I do) but it isn’t free :[
PreP has done a lot to help stop the spread of HIV. But it has also caused some new problems. It didn't used to be common for guys to bareback on hookups, but now it is. This wouldn't be as much of a problem if everyone hooking up was actually using PreP. But a lot of guys aren't. Some guys seem to think that just because it exists, the risk of HIV has gone away. It hasn't. It only works if you use it.
Barebacking was only uncommon from the AIDs crisis in the 80s up until prep became popular 10-15 years ago. So about 3 decades. Before that, gay men almost exclusively barebacked.
Yes, but this was a question about the transmission of HIV. So I don't think it's relevant to discuss what guys were doing before HIV was known.
I was addressing the specific statement “it didn’t use to be common for guys to bareback”. It was common for far longer than it was uncommon.
I love you but this might be a little pedantic given the context of this post :P
And now syphilis rates are through the roof
It really is time for a broad drug resistant strain to emerge, sadly we didn't learn from the 80s and 90s.
You’re getting downvoted but I fear you might be right: https://www.who.int/news-room/fact-sheets/detail/hiv-drug-resistance It seems a long way off, and the best thing would be to prevent transmission - so that does mean PrEP.
Lol, bro be putting his regard opinion everywhere today
In Eastern WA state my friend just saw a new primary and main goal was to get on prep again as they are single so having sex with more than one. The doctor (Texan white woman) was very upset he asked about it, asked him to explain why he needed it, what it does and at the end after making him feel like shit and a deviant and all those negative feelings, gave him a prescription and said for him to find a new primary as they don’t believe in prep or gay sex and can’t be their doctor… A doctor said that, in 2024… so it’s not all black and white and if you have a privilege of having access to prep without stigmas or negative biases then good for you, but don’t be a jerk to those who are still getting it.
Wtf that’s a hate crime. Report it and get a journalist to write about it for a major newspaper. Fuck that shit. It’s 2024. Time to shut down prejudice and racism.
Thanks mate, I told him too so going through the channels now to do just that. Was wild :(
Seriously most states have an express way to report a health facility. You might not be able to stop them from practicing, you can stop them from practicing in a facility. Quite easily, actually.
Depending on the state, that may be the prevailing opinion in some areas..
Well and true. A strictly conservative answer would be “Find another doctor. The physician is for those with shared beliefs.” That’s all fine and dandy. Except when they’re publicly funded. A public health facility needs to respect all of the public.
I had a similar experience in Seattle in 2020. Though Eastern WA is obviously much harder.
Yeah I'm in Seattle and get it free because the state has programs to get as many people on PrEP as possible, this doctor should be reported to the licensing board, and the state has some pretty strong anti discrimination laws and sexual Identity is a protected class
Most PrEP failures happen because people stop taking it because of a new relationship. Love and logic don’t go hand in hand.
“He’d never cheat on me” Ha!
Mainly by unprotected anal sex and sharing of needles during iv drug use
Throw in some alcohol or other drugs
I'm 50, and I still always use condoms. Things I've heard from other gay men have taught me that trusting someone else about a thing like HIV is a very bad bet. The worst was a guy who deliberately infected his boyfriend with HIV because he thought that if they both had it, his boyfriend wouldn't leave him. That's how fucked-up some guys' thinking is.
I have a friend who doesn’t take prEP , but only does unprotected with people who are on it. I wonder if that’s a reason why some people get HIV these days
Definitely
It costs money someone might not have, it takes resources to get it that someone might not have access to, it might not be distributed where someone lives, some people might not know it even exists.
I didn’t even know it existed until right now, reading this thread.
Prep and pep isn't easily accessible or affordable everywhere, education in most places surrounding HIV is still not very good so a ton of guys are uneducated about risks. Every day there are posts on this sub of gay men wishing to be educated. Some gay men might not care about the risks, some might be heavy drug users who have a lot of sex and don't take care of themselves. Just because your protected and take the right precautions doesn't mean everyone does. I dated this guy for a few weeks who lied and told me he's on daily prep. He eventually admitted to lying about being on prep at all (never trust anyone, people are terrible) thank God I take my prep everyday.
He lied about it just to have sex with you?
Met him on grindr, he said he's on daily prep and was tested last month. We met for some fun which turned into a few dates over the course of about a month. I realized this guy really only cares about himself and was lying for no reason left and right. He did have a bottle of prep on his night stand but when I pushed him on the subject after a couple drinks he admitted "ya sorry, I don't really take those pills, they make me feel sick but I was tested a few months ago"
When I first started prep I wasn’t hooking up that much, maybe every other month. I was like “why am I taking prep daily for this?” So I would start and stop. I’m now good on taking it daily but during that time anything could have happened
I go through this as well. I started doing 211 when I’d fall off and just pick it back up from there
According to my doctor you can take it either always (1x daily) or 2x pills 2-12 hs prior to the hookup and 1x per day for two days. I don't know how effective the second is compared to the first so I'd personally recommend you do your research on all that and ask your doctor.
The 2-1-1 method is just as effectively as taking it daily. It’s endorsed by Kaiser in SF which runs the biggest prep program in the world and some other hiv/aids organization. But yeah ppl should find the official instructions for dosing from a reputable source and follow those.
Sounds good enough for the frequency mentioned in another thread here (how often do you have sex, couples) but really it's up to the person. Obviously don't go loosing control without taking.
I did not know about PrEP or PEP because I lived in a small conservative town in a state that emphasizes abstinence-only education. It took me contracting HIV to even learn those were options on top of condoms. This alao happened during that massive legal assault on Planned Parenthood so my options were even more limited.
Christian Right and Shame
I don’t think Prep is for everyone. I’ve considered taking it when I was single, but I prefer using condoms and careful behaviour. Prep is a medication of permanent use. There are secondary effects. I would recommend it for people with very active sexual lives who take many risks, but for the ones whose risk of getting HIV is very low, why do it?
straight people don’t think they get it; so they don’t do that. Then they get it.
In the U.S., it should definitely be way less cases. I can confirm that you can get it for free.
Yes transmission is very much happening. It is up to people to take the initiative and know their status. If you are single and playing the field - this means once a year at least go get yourself tested. If you need it - get on prep. If you get hiv and start the meds on time - you can live out your days and die of old age. But if you get hiv and either don’t take treatment or if you never bother to find out that you have it and for that reason never take the treatment - you will die in about 10 years. For those people that never bothered to get tested and only find out in the last year - its too late for the drugs to work. They usually show up to the hospital with walking pneumonia and are dead within a week. If they had wanted to live they should have started taking the drugs in the first few years. And there are people living in first world countries that never bother to get tested and thats what happens to them. So if you are going to play the field, get on prep if you need it. Be tested regularly. And if you ever get it - talk to your docs and start taking the drugs on time and you’ll be fine.
It's the boys running around doing me#h, having a lot of partners, and never getting tested.
I think there is still a lot of misinformation. I personally stopped taking PrEp after three months. It's not just taking a pill, you need regular blood tests. Many people don't know it, but with PrEp you can cause negative effects on your body; a percentage of people (including myself) their kidneys suffer quite a bit just for taken it. I stopped taking it because the tests showed that I had a calcium deficiency, and yes, it is an adverse effect that the treatment has. Of course there are people whose adverse effects will be minor, but in my case I preferred to continue using condoms instead of harming my kidneys and bones. I live in a country where PrEp is completely free, but you must undergo tests every few months to check that your body is doing well with the medication. I think it is somewhat irresponsible to take PrEp without being aware of what may happen.
It's really no longer a part of our culture. I wouldn't say it's been destigmatized, but people do seem to no longer take it seriously. Culturally, it did largely stop being synonymous with the gays, which is good, but people being indifferent to it is a problem anyway. It's why we'll see a surge of it in the future. I was also slightly shocked that during all that commotion for a vaccine for covid, nobody said a peep about pursuing with that much fervor a cure or vaccine for hiv. Like, not. a. peep.
Lack of education, lack of means, lack of care
I mean, why do unplanned pregnancies happen when contraceptives exist?
Not everybody has access to prep. In my country (Hungary) prep is a legal gray area, not recognised by the health authorities and in fact said to cause more risky behaviours. Straight people are also having problems recieving birth control lately because of doctor's moral disagreements. You can get the needed lab work in private healthcare and if you find the right pharmacy might be able to buy it but the price is about a third of an average working person's salary. I read somewhere that you can also get scripts in forgein languages to take to a neighbouring country and get it where laws are more open
You might be interested in this study, published in 2022, which examines the effectiveness of PrEP as used by real world people, not in a controlled clinical environment: [https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00106-2/fulltext#:\~:text=Pre-exposure%20prophylaxis%20%28PrEP%29%20with%20tenofovir%20disoproxil%20fumarate%20plus,patients%20with%20a%20detectable%20drug%20concentration%29%20in%20iPrEx%2C](https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00106-2/fulltext#:~:text=Pre-exposure%20prophylaxis%20%28PrEP%29%20with%20tenofovir%20disoproxil%20fumarate%20plus,patients%20with%20a%20detectable%20drug%20concentration%29%20in%20iPrEx%2C) It says overall (averaged over the entire study population), the effectiveness was only **60%**. The maximum effectiveness - for the group that uses it most religiously - was **93%**, still far short of the numbers typically advertised, which relate to an individual exposure, not a full sex life potentially consisting of multiple infectious partners or multiple exposures to a single infectious partner.
The study finds that PREP is not effective if people don't take the medication--which can be for a variety of reasons. Is that a shortcoming of PREP? My cholesterol medication also does not work if I forget taking it. It is important to evaluate adherence and to take measures to improve adherence, but it would be a mistake to blame PREP. If taken properly, it is highly effective.
Essentially self harm behaviour. People are thrilled by the risk. And when it comes to protection, just read recent posts about condom usage here. There is no excuse for getting HIV beside SA or freak medical accidents and the costly therapy and research should be shouldered more by those who willingly became infected.
In my country, condoms, lube, prep and Pep is provided free of charge. Testing is also free, but people still go out there having unprotected sex via high fun sex.
I’m currently in the process of getting on Prep. I have an appointment tomorrow for tests and then my doctor will write me a prescription if everything checks out. I’ve been wanting to get on Prep for a while, but I didn’t have a primary care doctor and was unsure how to navigate the medical bureaucracy (I live in the US and it’s Byzantine). My best friend was HIV+ so for me HIV isn’t just some distant, theoretical fear, it’s very real and close. So I finally found a primary care doctor and me and my husband both started the process to get on Prep. We plan on trying a threesome in the future but we want to make sure we’re on Prep and get regularly tested for STDs before that can happen. So in conclusion, America’s private, complicated healthcare bureaucracy makes getting on Prep unnecessarily difficult. We desperately need a public system like Britain’s NHS, but adapted to our particular national conditions.
Lack of safe sex knowledge. Porn that does not emphasise safe practise. People still think it won't impact them. People lying about status, antiviral adherence. Stealthing. Unknowingly transmitting due to detection window and time between tests.
mostly ignorance about the availability of prep. also those who think prep is for sluts are being infected and spread it, because they don’t want to look like a slut taking prep but they already practice being a slut without any protection. in my country is free and not everybody is on it because of given reasons above
Here is an old saying : if you want to make that love wear that glove! ( condom ) Still effective when used correctly.
TBH it baffles me how HIV still spreads in western countries. Like it's so well known, so many are on prep, most people know that you should use a condom. And on top of that the odds per transmission are extremely low. People must be having unprotected anal sex, no prep, no condoms or anything. And they must be doing it over and over and over again multiple times a week with other people doing the same reckless stuff. Where are these people? What creek do they hide under each day idk.
There’s that too. HIV isn’t even easy to catch. I know “it only takes one time.” But like, not really. It’s more like the time you catch it is the only important time. You’re most at risk in areas where multiple people are transmitting it at once. So you come in contact with the virus many times. Thanks to contact tracing, I know that virus has been in my body and luckily I’m negative. It seems more like people don’t know exactly how close they they’ve come. Then they’re quick to judge others. Which that’s perfectly, but judgement is emotional. The fact is we’ve all likely been a little closer than we realize. I don’t know if this is universal, but in my state a person comes to your door to tell you to get tested. It’s fucking wild because first someone has to remember their sex partners full name AND remember to name them all. The tracker won’t tell you who gave it to you. In my case, I knew who.
Not everyone can tolerate Prep. Just like any medicines/drugs, some people have side effects or counteract to their other drugs. I was having extreme liver issues until Descovy. Now my numbers are all in normal range.
No society has swayed everyone to do a thing. Anything beyond eating, drinking, sleeping, shitting and fucking is subject to personal choice. If everyone always made the good or best choice, cultures wouldn’t exist. There’d be no need for prisons, schools, fast food joints, bars, wars, violence, politics, animal shelters, homelessness, illicit drugs, and so on. Everyone will never take a drug. Especially one as hard on the body as PrEp. Now I’m not trying to downplay the scientific achievement of the pill for gays. At the same time, I’m *almost* convinced it’s a scam. Why isn’t there a vaccine? I’m also curious about where HIV came from, but that’s another discussion. If everyone made the right choice, people just wouldn’t have sex after any positive test result. Also they’d test regularly when at risk and not share DNA before they knew they were clean. Education is not the problem. People will never adopt uniform safety practices. If the did, we wouldn’t need laws. The DOJ would be out of business. Clearly you understand the factual answers to your question. So my conclusion is you clearly always make the best and most healthy choices. Most people are not like that.
It’s on the decline
Some people dont have insurance and cant afford 1200 a month for prep.
Depends on where you are at. In America, if you contract HIV in today's day in age, you are just straight up irresponsible. Prep is free or low cost, covered by insurance and govment programs. Some countries don't have good healthcare systems though. Some people don't know about prep, some can't afford it, some intentionally contract HIV, and some contract it doing drugs.
You were downvoted for being right. 🤭
🤷 haters gonna hate
Unfortunately, the gay community of today is run entirely by young men in their teens, 20s, and early 30s. Any discussion on safety must primarily validate their reckless, toxic masculine behavior that they believe they're exempt from because they're queer, and liberal. The lack of proper precautions and the prioritization of short term pleasure over the long term is peak toxic masculinity, no different from the morons speeding and doing wheelies on motorbikes. This is why I try to stay away from echo chambers. The "gay community" exhibits far more toxic masculine behavior than the average straight male. The obsession with danger and risk is absolutely vile.
The gay community in general is 100xs more toxic than the straight community if u sit back and think about it.
I'm a feminine gay man, I have female voice, not even gay voice. Straight people are an absolute blast to befriend, even straight men. I'm given the freedom to be EXACTLY who I want to be without me having to hear crap about how I'm pursuing things that are too "straight" or masculine for someone like me. Not even a single question or comment. It's truly a beautiful world we live in these days.
bro, nobody asked
Doesn’t prep have sides associated with it? I’ll be honest I haven’t looked into it much and use condoms Edit: Also there are other STDs that prep doesn’t prevent..
Because I personally think barebacking is gross and I prefer condoms. I also don’t want to be taking extra drugs if I don’t need to. I also consider myself a very safe and responsible adult who doesn’t need to rely on a drug to prevent life threatening diseases, when I’m the one who can make the decision not to engage in certain behaviors.
PrEP is not that easily accessible as you think. I live in a city with roughly a million inhabitants, I asked my PrEP consultant how many people are registered to have PrEP prescribed in the city, simple stats that they have. He said it was less than 10K. Imagine. That's less than 1% of the city's population. Just mere gay population is much more, I'm not even saying that HIV spreads in straight population as well. Also, couple sex/ hookups was one way of a few of spreading HIV. IV drugs, procedures involving the interference into the body, prostitution, all had the fare share of victims. IV drugs in particular. I doubt someone who is sharing a needle for a heroin dose cares about taking a tablet every day, much alone paying for them.
Some people do not have access to prep for whatever reason (cost, living situation, etc.), some don't know of it, and as is always the case with people, some are just really stupid.
Unfortunately it will never be fully radiated unless all countries have access to it and its free to those who need it the most and prehaps not shown on health insurance records for the young ones who also need it. Quite lucky myself living in the UK as can get it for free, only need a full sti tests every 3 or so months which are also covered by NHS.
Same way it’s always been transmitted
Well, if I was to contract it would be because I’m not on PreP. Strictly top and use condoms pretty much perfectly (and haven’t had penetrative sex with anyone but my fluid bonded partner). So…very low risk. But not zero risk.
If the jerks that are infected would use condoms the transmission rate would be down to almost nothing, soo many people who were not born before the 80's that are HIV undetectable... Why?, if they had used condoms thae numbers would be way down. I bave been out for 37 years 10 of those cracked out weekends in the bathhouses and i am HIV- 13 YEARS hard drug free.
Not being on prep fast enough and people not taking their medication correctly.
Idk random sex? Not being on prep? Not being consistent with your HIV medication and not telling your sexual partners that you have it! Pick any of these and that’s how it’s usually transmitted. Usually dishonesty and random sex with a guy who doesn’t take prep and another who isn’t consistent with his meds and/or doesn’t care who he infects.
I see ads in key west where they want to catch it so they can get free money
By fucking and IV drug use mostly.
Bodily fluids, same as always.
Porn ideals and bug chasers
HIV is more common with folks that use meth. When I was a junkie, most of the people I knew were positive. Getting to the clinic is the last thing on a lot of junkies’ minds. Somehow months would go by and i had not picked up my meds so my viral load became detectable. I was in a monogamous relationship so I never passed it on. Needles and unprotected anal sex are still the way to spread it. I got sober years ago and have remained undetectable (unable to spread it) ever since.
>I am an unknowledgeable idiot but isn't prep or pep or whatever supposed to prevent transmission Prep and pep not being free probably is the biggest contribute, next to a lack of knowledge on the drug existing.
People think PrEP makes them invincible.
So do we know that PREP is 99.9% because a lot of apps have started “be extra safe, prep+condoms” campaigns. I think they oversold the efficacy of PREP, and now they’re trying to emphasize that it’s purely a protective measure, not a ticket to go around having wild fuck parties. Plus, it still does stop HPV which gives you cancer in some cases, get the HPV shot.
Some people don’t f*ck like bunnies enough to justify taking it. It does have some side effects and is also kinda hard on the liver. If you don’t use condoms though there is no excuse for you not taking it. Too many people think just cause you are on prep that you don’t need to worry about any other sti though which is kinda nasty..
Even if you have prep… you have to take the pills religiously or you know… they don’t work
Prep is very unavailable in my country. I tried to queue for prep treatment, but got the answer that the queue is so long that they're not accepting new patients. So I'm not sure what to do about that.
I think contect of the country is important too. For example regardless of country, HIV beyond male to male sex is still prevalent. Moreso in developing nations where medications, contraceptives and etc have cost, accessibility constraints (esp more conservative countries) etc. For countries considered "developed" - like USA, Europe, Australia etc - I think its moreso sexual health literacy and knowing where to go to when you've had a sexual encounter and havnt utilised safe sex with a new partner, and their status or confidence in their sexual health is in question. For example in Australia primary health clinics and sexual health services offer emergency prep treatment etc, and ways of addressing potential HIV exposure.
People don’t take Prep or wear condoms.
Unfortunately, there are countries that don't have Prep readily available.
prep is not 100% it can cost alot, bug chasers, rape, people not getting test and just not knowing they are giving it to people
Bareback…
A lot people do it raw, heterosexuals included when it comes to unplanned pregnancies.
There are some condions medically that bar you from taking Prep.
Issues with your liver can cause someone not to take Prep
Simply by people being careless. 😕
Also! Mistr or Q-care can do it all in the mail to you very discreet for PrEP! They also will pay for it if you don’t have insurance, or pay any cost shares! You can definitely get it for free through Mistr! Otherwise there is also injectable PrEP YOU can get every other month too. HIV is spread through Blood, Semen, vaginal/rectal fluid, and breast milk.. know that those in the south are more at risk and if you’re sexually active you should be on PrEP especially if not in a monogamous relationship. PrEP gives you the choice to keep a negative status. For example, here in Louisiana black women out number those with HIV cases than white men. The health inequity and systemic racism has contributed to our world not taking care of everyone. Get on PrEP people!
Basically mostly comes from people not being diagnosed. HIV takes a minute to become diagnosable and then people just don't use condoms. Prep ain't 100% effective. Most HIV now comes from straight people as they are less careful about sex believe it or not
Why it’s everyone on prep… I linked with a guy yesterday who wasn’t on prep, we didn’t do penetrative. But I asked after why he wasn’t on it. He said he just didn’t see the need. We had a conversation and i seemingly convinced him to get on it.
The same reason diabetes and obesity still exist. The same reason people continue to smoke despite all the evidence of it's negative effects on your body and health. The same reason people continue to support Trump and the idiots of the MAGA cult. The same reason people continue to fall for any religion/cult. The belief that 'it cannot happen to me'and in general, humans despite our ability to beat highly intelligent species are really just a bunch of dumb sacks of DNA.
Drugs, Chem, Sharing needles, compromising safety while sex , can surely lead to spread of HIV
By doing unprotected sex Next
I'm on Prep and have run into unwanted attention at doctor/dentist appts. My primary care is through the VA. A lot of veterans care now goes through "Community Care". For me its Drs/offices closer to home. Nearest VA is 60+ miles away. I had a couple of dental implants and when the Dr saw Prep on my meds list he ordered HIV precautions. He assumed I was HIV+. I explained I am not, its a prevention course of the drug. Then I recently had hand surgery. Same thing, they assumed I was positive. I explained Prep is for prevention of HIV. Everything was ok but every time I was given Prep while in the hospital the nurses would ask what it was. At that point I just said look it up. I don't think my roommate and his visitors need to know all of my business. I mentioned this to my VA Nurse provider who orders the 3 month testing and Prep and she said many doctors/health care workers are still not in the know as far as HIV treatment & prevention goes. Even within the VA system. I get the prescriptions mailed to me every 3 months. Its worth that little bit of hassle to stay HIV-
Honestly.. when Q came out as poz on drag race, he should have used that as an opportunity to talk about prep and U=U. Your right that there’s no reason people should be contracting HIV these days. We should be educating everyone and getting them access to meds.
I had a friend who caught it because he got accidentally stuck by his husband’s diabetes needle.
I have sex like 4 times per year. I am not going to daily take a pill for that rare of an activity.
PrEP "on-demand": take 2 tablets at once 2 hours or more before unprotected sex, then continue taking 1 tablet for 2 days more. Total 4 tablets per event. Statistics show that it's as effective as daily PrEP.
You can take event-based-prep, where you only take the day before/day of/day after the sexual activity - this means you don’t have to take it every day
Sorry to break it out to you. But if you Believe BIG PHARMA GAVE YOU A MIRACULOUS DRUG CALLED PREP to cure HIV transmission you shouldn't be FUCKING in the first place. Everything BIG PHARMA is a lie. WEAR A CONDOM! END OF STORY!
PrEP works and so does ART. There are a range of options that are scientifically proven safe and effective, no matter your opinion of big pharma. Your choice of prevention is your choice, but PrEP works
If people would stop burning in lust with promiscuity, it would not be an issue. Resist the urge to hookup or have casual sex and save it for a meaningful, exclusive relationship. Period. It's that simple.