PrEP Enables Us to Return to the Sexual Revolution of the 70s & Improve On It

Tue, 03/17/2015 - 08:06
Submitted by Anonymous

We decided to defend ourselves from the greatest threat to sexual liberty: getting HIV from sex. We're now on PrEP. PrEP means taking Truvada, a key anti-HIV medication, daily. Do that and you've cut the likelihood of HIV infection due to sex to close to zero.

HIV no longer means a death sentence. HIV brings a far worse consequence now. Getting HIV is incurring huge financial/career & social handicaps. The costs of HIV are your prime reason to consider taking PrEP now.

- Living with any major long-term disease - whether cardiac, breathing impairment, diabetes, cancer - generates extensive out of pocket costs. This only gets worse as related conditions appear, medication effectiveness wears out, and aging occurs. the high costs in time and money of managing HIV and coping with the side effects of HIV medications - not to mention as you get older. Living with HIV becomes living defensively. Many decline promotions that might involve extensive international travel, demanding hours, and extra stress.

- The risk of contracting HIV is the risk of acquiring a Scarlet A. It's a cloud over every sexual encounter. A broken condom - and 20-40% of them break! - can become a disaster. Giving in to a partner can be a dangerous proposition.

- HIV stigma is real. Serodiscordant couples suffer extra pressures. Dating becomes handicapped by the "is he or isn't he" question. People with HIV end up socializing with people with HIV. Support groups replace normal socializing. The parTy scene with crystal meth often results in HIV infection. Just the fact that with the internet people have more partners
- not to mention more imaginative sex - puts many at risk.

You don't die of HIV any more but your life gets messed up and miserable if you seroconvert. You're then far more susceptible to HIV-related conditions. You now have a rigorous schedule of monitoring and managing your HIV condition and medications. The medications wear out and need to be changed - and each change can be accompanied by debilitating side effects. In other words: HIV is no picnic. It's very costly. And it'll transform your life - for the worse.

Given all this, why wouldn't you take one blue Truvada pill daily to immunize yourself from all this? From a financial and risk management perspective alone, this is a no-brainer.

Or, let's put it this way: if someone said you could eliminate contracting cardiac disease, or cancer, by taking a single blue pill daily - would you do it? Of course! in the flash of an eye.

But the problem is there is no blue pill to prevent contracting cardiac disease, diabetes, eye conditions, cancers - but there is one that can prevent of HIV disease.

So why aren't all of us who are sexually active using it?

PrEP could change the current climate for relationships & love radically. What if the worry - "is s/he negative? is s/he diseased?" - disappeared from dating. Maybe we could pick up sexual liberation where we left off - but really do it better this time.

So why aren't more sexually active people going on PrEP? and taking that blue pill? Deep down? shame and guilt about sex. Yep, those old demons are very much alive and kicking. Look in the mirror. Reflect.

Why are the media silent about PrEP? That's easy: when did the media ever talk openly about sex except as an aberration or abuse? We're no longer proud of our sexual identity. Of being intensely sexual beings. Thirty years of HIV did that. And PrEP's little blue pill can undo it.

Sex has never been more accessible, easier to arrange. Personally we have evolved into immensely sexual beings. Many more have more sex with more partners - sex on the fly, hookups. Our sex sites enable us to arrange a sex connection in an hour - conveniently - few questions asked. Date rape, simple mistakes & wrong risk management decisions are rampant. We need protection that'll work in the face of all of this - and only PrEP does that.

Is PrEP too expensive? Ask your health plan. That's been used too long as a limitation on our sexuality. Our health plan readily paid for it. Our health plan's deductible of $500 was already met by February and all we had to make next was our out of pocket max of $750. After that? it's free. No charge.

How expensive is the monitoring and management and care of HIV disease. Unmanaged and unmonitored it'll kill you. Managed and monitored it'll cost you out of pocket easily $10,000 a year: ten times as much.

Not to mention the opportunty costs. HIV puts a brake on life. It becomes an anchor we drag behind us. Its questions are pervasive: when are things going to get worse? when will the current meds lose effectiveness? Should I cut back on my career? can I invest in that apartment or house? can I take that trip? Is rest and care more important than career opportunities? The fear of HIV will fill you with opportunity costs: career leaps not made, relationship possibilities not explored.

Simply put, without PrEP you're never going to give your life a full shot - you'll never fulfill your potential. Isn't that worth paying for PrEP until you deductible and out of pocket maximum kick in?

I wrote an entire article spelling out the costs resulting from HIV infection. Co-pays for treatment, frequent blood tests, and monitoring visits. Alternative care visits to acupuncture et al. Unreimbursed alternative medical treatments such as nutritional supplements. More copays due to the onset of HIV-related conditions like lipodistrophy, diabetes, increased cardiac risk - there are a dozen that are more than likely to occur.

Believe me. HIV medication has only eliminated death. It has not eliminated this living hell. Contracting HIV is a financial nightmare.

Being on PrEP ensures financial stability by eliminating HIV as a risk. It's simple: Do It Now.

Save yourself a lot of bother and go straight to a gay & lesbian health clinic like Callen-Lourde in NYC. You can drop in on Saturdays (go early!) and see someone quickly. Even if you just get a HIV test or counseling you're then a C-L patient - and you're eligible to go on PrEP.

And if you've had an episode where you fucked without condoms, even topping - which is very low risk - you can hustle your ass down to C-L and if it's within 72 hours of The Incident you can go on POP - taking the PrEP medication, Truvada, along with another anti-HIV med, Isentress. Take it for 30 days and after that you can request to go onto PrEP, Truvada alone.

They'll test you for every STD known to man (knowledge is power, remember?). They'll check your baseline figures - and monitor the effects if any on your body.

Side effects from this medication are neglible: in the 2-5% range primarily in the first month. We've had none.

Efficacy couldn't be better: 99%+ - and if you mix up the pills and take them irregularly the efficacy is only lowered to 97 - 95%. Clearly taking the meds regularly is in your interest.

What does this mean? An end to the guessing game. Is he negative? positive? does he really know? It means going unsheathed if you're fucking - and frankly with these statistics even if you're being fucked. It means a return to worry-free sex for those older. It's truly revolutionary for the young.

Common sense needs to govern: not having an unknown partner cum in you in your nether parts. Don't share needles. But that's pretty much it. Isn't this sexual liberation???

The only question remaining is: why aren't you on PrEP now?

And frankly your sexual partners will start crawling out of the woodwork. People on PrEP are a prime commodity. A no risk commodity. You can do with them what you will. Isn't that everyone's sexual liberation dream?

PrEP enables us to return to the sexual revolution of the 70s - and since we've learned a lot since then - improve on it. It's simple. Do it.

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Truvada & UK

Wed, 03/18/2015 - 12:43

A recent study of Truvada in the UK showed it cut HIV infection by 86% under "real-world" conditions ie. people were left to take the pill or not on their own. There had been some concern that people would be careless or forgetful and maybe that pushed the efficacy down somewhat in the trials but 86% is still pretty good.

They're now looking at making it available free to high risk men which has to be good news. Once the NHS starts to buy in bulk hopefully the price will just be pushed lower and lower. Good news all round.

Sex is a wonderful thing, but

Wed, 03/18/2015 - 14:46

Sex is a wonderful thing, but to have endless sexual parters is both to ask for trouble and to risk giving trouble to someone else. HIV is perhaps the most dangerous sexually-spread disease, but it is far from the only one. The more partners we have and the less well we know them, the more we put everyone's health in jeopardy. A few minutes of fun is not worth a lifetime of suffering. Any remedy should be welcomed, but among the most sensible and easy remedies is to modify our behaviour so that we take fewer partners and are always conscious of protecting the health of all.

What about those with no health insurance?

Tue, 12/08/2015 - 03:23

I agree Truvada is seemingly an amazing drug to protect ourselves from HIV, especially if our partner is postiive. I recently became sexual with an HIV positive person. My plan was to get on Truvada before having sex with him, but it didn't happen that way. I plan on getting Truvada, but it's not as easy getting it as you presume. I lost health insurance, and I am struggling financially to even pay my bills. The city's (Portland, OR) STD clinic does not have the funding to provde it. It has to be prescribed by a doctor. I am hoping that maybe Planned Parenthood can help?? I live in a small town but will be moving to Portland soon. I am feeling stuck by not having health insurance. Our health system is really limited in the US, and you did not acknowledge the limitations in getting Truvada. 
Also, you did not bring up the advances in the medications given to HIV positive people and how those with a low or undetectable viral load have a significantly lower transmission rate. 


Fri, 04/08/2016 - 06:23

On March 21, NHS England decided against expectation that it would not proceed with a scale up of PrEP for prevention of HIV infection among at-risk populations. NHS England said it was "not responsbile for commissioning HIV prevention services"  passing responsbility back to the government.

The decision has outraged HIV charities and activists. It seems that HIV is no longer widely seen as a killer disease. In times of scarce resources, it is no longer a healthcare priority.