Join him, and us :)
Jumat, 01 Mei 2015
[VIDEO] Ken Like Barbie: The Frontier of HIV Prevention is Changing - A Video Fact Sheet on PrEP
Join him, and us :)
Rabu, 29 April 2015
"I have a responsibility to volunteer in the Next-PrEP study"
by Daniel MacDonaldMy support for PrEP up until now has been solely offered sitting at this keyboard.
Now, it's time to step back into the street one more time.
I knew I was gay since I was 13. This was back in 1977, so being gay wasn't as socially acceptable then as it is now, but I didn't care even then. I liked guys, that was that, and I didn’t care who knew it. When you knew someone who was gay, well, “gay” was always said in a hushed whisper. I lost my virginity that year to a much older man I would spend the next nine years with. The sex was a fantastic event with him every single time, and being a healthy teenager, my sex drive was nonstop. We would spend the day shagging like dogs, and because we were in an open relationship we would invite others to come join us for the naked festivities.
Things would take a dramatic turn when a scary illness and rare cancer began to show it's face before I hit 25 years old. The flow of information stunk at that time, and there was far more misinformation than actual fact being shared, and it would quite a while before the disease had a name (and we all thought it sucked back then, too.) Great. Now anyone in the family who didn't care for my being a big ol' homosexual now had ammunition. If you don't settle down and get a girlfriend you're gonna get that gay plague and die. It'll be God's punishment for what you're doing.
Please. I tried girls, and the only way I enjoyed them was if they brought their boyfriends along for the fun and we had a bisexual romp. I’ve given more than one curious couple a night to remember for both of them. Told you: I'm a total horndog.
The name of the gay plague changed to something a bit more acceptable, but it was no less scary. My friends were dying, nobody was helping us at any level, and the only protection we had at our disposal if we didn't want to become HIV positive was to wear a condom. Now, let me tell you a bit more about me: I'm a big guy. When I finally stopped growing, I landed on 6 foot 6 inches. Nature also blessed me with a nice set of muscles on this gargantuan frame, and an appropriately sized cock - a true 10 inches and 7 around. That made me the most popular guy at the dance - a fact that I used to my advantage in my personal sex life, as well as rounding up tricks I "escorted" and a brief career in porn. All the sex I want? For money? And how many people will be watching? Well, sure – what the hell. Count me in. My most memorable scenes are probably in that box in your attic.
Finding a condom that I could actually get on was a ridiculous lesson in futility. When I could find one that had possibilities, it felt like my cock was being mugged.
Need a picture? Think of stuffing five pounds of sausage in a three-pound casing. I got them on - barely. They were painful, hard to roll down, and slid off while I was fucking. So the fear of HIV dictated a very uncomfortable, unsatisfying sex life for years. And because I couldn’t get a condom to fit me, I went from being versatile to total bottom. Sex was losing that wonderful fascination and becoming more of a scary chore than anything, and I funneled all that pent up sexual energy into HIV/AIDS advocacy; a passion that's followed me to this day. If there was a demonstration, speech or action taking place that I could get to, I was going to be there. I'd watched too many of my friends die, and too many senseless seroconversions involving people who didn't know all the facts about HIV.
Flash forward a few years to the mid-1990s. The man who took my virginity is out of the picture and now I'm with a wonderful man who I love intently. He's HIV positive--a fact I knew about him before I could spell his last name. And I'm HIV negative.
Together we had to find ways of discovering a satisfying sex life without my seroconverting. The meds of the day weren't what they are now, and I knew from my boyfriend’s complete transparency around his HIV status that he was sporting a big viral load. The word “undetectable” in regard to his HIV didn’t come up much those days. While there was no reason for us not to have sex, it came with a lot of caveats. We tried mutual masturbation. We tried me on top wearing a rubber. We tried him on top, wearing a rubber, which totally killed it for him.
Could you stay in the saddle with the question of "what if the condom breaks?" lurking in the back of your head? He couldn't either; especially on the day it did break.
He pulled out, and as was his habit he’d inspect the condom and damned if it didn’t happen. We spent the next few days waiting for my HIV test results and my boyfriend was in a morbid funk, and understandably so. He was overwrought with guilt at the prospect of my contracting HIV from him, and I had resigned myself to getting my results and hearing that I was positive. It was nobody’s “fault” and if it happened, it happened; so be it. The test came back negative; as did all the other subsequent tests I took afterward as a safeguard. During every single wait period for results, my heart broke for my boyfriend and the self-imposed guilt he was swimming in. Finally, we tried him watching while I fucked with other negative guys, which was probably the worst, most alienating idea of them all. His participation in those romps wasn’t nearly what it needed to be, and it wasn’t satisfying for either of us.
You get the idea? We loved each other but our sex life at the start left a lot to be desired
These days, meds are better if you're HIV positive, and condoms come in more varieties. And I'll tell you a secret: I don't always use them. I know that’s blasphemy for me to say as an HIV/AIDS advocate but there it is. Sometimes the waves of testosterone come crashing ashore, and common sense goes out with the tide. I still have some issues finding ones that will fit, and female condoms aren't as universally accessible as I'd like. I have no problems negotiating whether or not we use them when the time comes. If I'm with someone who says they're negative I expect them to prove it; I'm not naive enough to take someone at their word. It takes more than a guy giving me a hardon before the gloves come off - if you get the drift.
Enter PrEP.
What an out of the box thought, right?
Lots of people aren't using condoms, and these medications - if taken as they're supposed to - have the potential to dramatically decrease the possibility of becoming HIV positive.
According to some studies, PrEP can be 94% effective--which makes it more effective than condoms. Now, imagine the efficiency in preventing HIV if someone is on a PrEP regimen and using condoms. I've read all the studies and I know that number is constantly in dispute depending on whom you talk to.
So I've signed up for the Next-PrEP study and I’ve been accepted. For the next year, I will be taking a combination of three pills but will have no idea which particular arm of the study I’ll be in, so there is a minimum of one placebo and a maximum of two active drugs as part of my daily routine.
I met with the study directors from day one, and every one of them has been wonderful. The flow of information is amazing; they really leave no question unanswered. I was given a full-on explanation on everything from how HIV works, to what medication is designed to do what, to a soup to nuts explanation of the study’s goals and my role in helping get their data to the finish line.
Will there be side effects? There just might, and I was given a ton of documentation on what I might have to work through. But that's not too much of a concern as they usually pass over time as you continue to take the meds. There are layers upon layers of people and boards monitoring the safety of all participants, so I know I won’t be thrown in the deep end all on my own, or that I won’t have any safety net if I do have something go awry while I’m participating in the study. There are also regularly scheduled doctor visits and tests that will keep an eye me at all times. All of the people I've met in this trial couldn't have been more friendly and helpful.
And my sex life during the study? I’m not expected to do anything different – so keep on, keepin’ on. Which means, well, usually busy. (I’m still that horndog that I was when I was a kid.)
I know these pills aren't going to make me 100% bulletproof against HIV--nothing short of complete celibacy will do that. But consider this: the HIV prevention message of "always use a condom" is over 30 years old. It’s the safe sex equivalent of a warning on a pack of cigarettes. Everyone knows the message is there, they know what it’s saying. They know if they don’t follow the directions, something bad will happen, but they will still buy a pack of smokes if they want one. Or they’ll have bareback sex knowing full well they might regret it when it’s time to get their next HIV test results – if in fact they are even testing. I can’t count the number of times I’ve been chatting openly with people about HIV and testing and I see that hang-dog expression on their face when they tell me that they haven’t tested in a long time - or at all. Or they can’t remember their last test.
People change, lifestyles have changed and there's a new generation coming up that hears the message of safe sex without the urgency that I did when I was their age.
My son, who's also gay, has been sexually active since he was 15. Up until the time I adopted him, he thought of HIV as a mythical beast that wasn’t a threat to his existence. He’d never heard of Hepatitis B or C, and didn’t know much about STD’s. As a father, the possibility of medications being readily available for him as an effective prevention measure against HIV is something I find very exciting and promising. And you better believe he knows how to put on a condom now, as well as where to find them free all over the city (if he’s not raiding my stash).
The very definition of safe sex is changing, and it needs to.
Gay men aren't using condoms, and it's not about finding a new message to make their importance more prevalent. My son had been having a rowdy sex life a year before I adopted him, and he had no clue how to put a condom on. The message needs to be changed to convey that, while condoms can be effective, there's another way to ensure your protection. There are those in power who preach that a pharmacological solution to HIV is a disaster and will try to make you believe that everyone who's got access to PrEP will toss their condoms away for good. They'll try to tell you that Truvada and PrEP is a magical pill solution that does nothing more than give up on gay men. I've written page after page making sure you don't buy their half-baked cake.
Consider this: I've had a very active sex life for the last 36 years, and I'm not even 50. I've been a male prostitute, gay porn performer, live sex performer, and I'm still an HIV/AIDS advocate. There's been tons of great sex in my life, and there's probably a ton more before I hang it up for good (hopefully when I'm in my 90's). There is also no logical reason why I'm still HIV negative. I have no explanation on why I've never contracted a single STD. I also know I'm not bulletproof either, buster. More than three decades after I watched my first friend die from AIDS, we still don't have a cure.
To me, I have a responsibility to volunteer in Next PrEP, even though I’m going to be one person among many who have stepped up for this trial. I need to be there, as a gay man, a father, an HIV/AIDS advocate, and as a journalist who’s got an active, fulfilling sex life.
My support for PrEP up until now has been solely offered sitting at this keyboard.
Now, it's time to step back into the street one more time.
Selasa, 28 April 2015
"Today, I no longer need PrEP, but I remain very grateful for it."
by James LoDuca
[James is Vice President, Philanthropy & Public Affairs at San Francisco AIDS Foundation. This was originally published on Huffington Post. Check out SFAF's fantastic PrEPfacts.org - a wonderful resource on PrEP.]
PrEP may not be right for everyone, but everyone deserves the chance to choose.
Two years ago, something unexpected happened. I was seven years into an incredible relationship. We married in 2008 during the brief window when it was legal for same-sex couples to wed in California, and my husband and I became poster boys for marriage equality (really -- our wedding picture was on a poster). We initiated the process of adopting a child. Never in my life had I been so happy.
Then, suddenly, my husband shared news that I hadn't seen coming: He wanted something different and would be filing for divorce. My world crumbled. The next six months were the most painful of my life. I couldn't sleep, lost my appetite, and went numb inside.
On the outside, I refused to show it. I started dating, went out to bars, and even made some decisions in the heat of the moment that I normally wouldn't. I was determined to convince the world (and myself) that I was fine. In retrospect, it was a fairly common response to intense emotional trauma.
My doctor wasn't fooled. He referred me to a therapist to start the hard work of healing. He also prescribed Truvada, a drug that protects against HIV infection. It's a groundbreaking HIV prevention strategy known as pre-exposure prophylaxis, or PrEP, which has been proven highly effective when taken correctly. PrEP is an especially good option for people during "seasons" of risk, or for anyone who struggles with perfect condom use 100 percent of the time.
AIDS Healthcare Foundation (AHF), the largest U.S. provider of HIV/AIDS services, is spending millions trying to position PrEP as controversial and deny access for people like me. Following a failed attempt to block FDA approval, its current tactic is to demonize the drug and shame its users. On social media, rhetoric from AHF's campaign against PrEP often crops up in posts on the topic. It's strikingly similar to the "controversy" that initially accompanied FDA approval of oral contraception for women. In the early days, single women who sought the pill to prevent pregnancy were labeled "whores."
When it comes to HIV, the idea that condomless sex with PrEP can also be protected sex is novel. As time passes, it will become less so. This isn't the first time AHF has fought progress by taking a position that ignores scientific evidence and sets it apart from the HIV/AIDS community. Some suggest the organization manufactures controversy to keep its name in the headlines and stay relevant.
Progress isn't possible when shame is present. It's time for a more humane and loving approach. We must come together to foster compassionate dialogue grounded in scientific evidence about all of the available options to protect ourselves and take care of each other. That is the only way we will end HIV transmission.
Research has repeatedly linked shame and stigma to the very behaviors that put people at risk in the first place. That was true in the case of my divorce, and as my healing progressed I overcame the shame and stigma that accompanied it. I got an STD during my personal season of risk, which was promptly identified and treated. PrEP doesn't protect against STDs, but it does increase opportunities to identify and treat them, because PrEP requires regular screening.
PrEP may not be right for everyone, but everyone deserves the chance to choose. Nobody should be allowed to take that away. We must work together to educate, empower, and support each other, and beat back dangerous attempts by any person or organization attempting to block access or shut down dialogues. Today, I no longer need PrEP, but I remain very grateful for it. Just like I'm grateful for all the friends and family who provided the unconditional love and support that I needed to help get back on my feet.
There's a sort of beauty in falling apart. When you put back the pieces, you get to build a better version of yourself. In my case, that version did not include HIV infection. I can't help but think that if AHF had its way, PrEP would have never been approved, and my story would be different.
[EDITOR: If you have a personal PrEP experience you would like to share, send it to myprepexperience@gmail.com. Words or video.]
[James is Vice President, Philanthropy & Public Affairs at San Francisco AIDS Foundation. This was originally published on Huffington Post. Check out SFAF's fantastic PrEPfacts.org - a wonderful resource on PrEP.]
PrEP may not be right for everyone, but everyone deserves the chance to choose.
 |
James, left, pictured with Chris, one of his closest friends who helped him through his divorce. |
Then, suddenly, my husband shared news that I hadn't seen coming: He wanted something different and would be filing for divorce. My world crumbled. The next six months were the most painful of my life. I couldn't sleep, lost my appetite, and went numb inside.
On the outside, I refused to show it. I started dating, went out to bars, and even made some decisions in the heat of the moment that I normally wouldn't. I was determined to convince the world (and myself) that I was fine. In retrospect, it was a fairly common response to intense emotional trauma.
My doctor wasn't fooled. He referred me to a therapist to start the hard work of healing. He also prescribed Truvada, a drug that protects against HIV infection. It's a groundbreaking HIV prevention strategy known as pre-exposure prophylaxis, or PrEP, which has been proven highly effective when taken correctly. PrEP is an especially good option for people during "seasons" of risk, or for anyone who struggles with perfect condom use 100 percent of the time.
AIDS Healthcare Foundation (AHF), the largest U.S. provider of HIV/AIDS services, is spending millions trying to position PrEP as controversial and deny access for people like me. Following a failed attempt to block FDA approval, its current tactic is to demonize the drug and shame its users. On social media, rhetoric from AHF's campaign against PrEP often crops up in posts on the topic. It's strikingly similar to the "controversy" that initially accompanied FDA approval of oral contraception for women. In the early days, single women who sought the pill to prevent pregnancy were labeled "whores."
When it comes to HIV, the idea that condomless sex with PrEP can also be protected sex is novel. As time passes, it will become less so. This isn't the first time AHF has fought progress by taking a position that ignores scientific evidence and sets it apart from the HIV/AIDS community. Some suggest the organization manufactures controversy to keep its name in the headlines and stay relevant.
Progress isn't possible when shame is present. It's time for a more humane and loving approach. We must come together to foster compassionate dialogue grounded in scientific evidence about all of the available options to protect ourselves and take care of each other. That is the only way we will end HIV transmission.
Research has repeatedly linked shame and stigma to the very behaviors that put people at risk in the first place. That was true in the case of my divorce, and as my healing progressed I overcame the shame and stigma that accompanied it. I got an STD during my personal season of risk, which was promptly identified and treated. PrEP doesn't protect against STDs, but it does increase opportunities to identify and treat them, because PrEP requires regular screening.
PrEP may not be right for everyone, but everyone deserves the chance to choose. Nobody should be allowed to take that away. We must work together to educate, empower, and support each other, and beat back dangerous attempts by any person or organization attempting to block access or shut down dialogues. Today, I no longer need PrEP, but I remain very grateful for it. Just like I'm grateful for all the friends and family who provided the unconditional love and support that I needed to help get back on my feet.
There's a sort of beauty in falling apart. When you put back the pieces, you get to build a better version of yourself. In my case, that version did not include HIV infection. I can't help but think that if AHF had its way, PrEP would have never been approved, and my story would be different.
[EDITOR: If you have a personal PrEP experience you would like to share, send it to myprepexperience@gmail.com. Words or video.]
Minggu, 26 April 2015
CDC "Cheat Sheet" on PrEP - Fast Facts for Providers
Check out CDC's Interim Guidance on PrEP for providers in this handy "cheat sheet" below. For more info on PrEP via CDC, click here.
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| click to enlarge |
Sabtu, 25 April 2015
[VIDEOS] Ken Almanza Captures the Early Days of His PrEP Experience
I just incorporated it with my regular allergy pills I was already taking.
No big change. Stay tuned ...
Ken Almanza does HIV counseling in Los Angeles, and has recently begun taking Truvada as PrEP. He has been documenting his journey with short videos on his FB page - you can see the first three below.
Follow him if you want to keep up on his PrEP experience. He also posts great info on PrEP as well.
And, he's charming. And guapo. So there's that.
Post by Ken Almanza.
Post by Ken Almanza.
Post by Ken Almanza.
PrEP – How did I end up here? [Part 2 of 3, by Marc-André LeBlanc]
bv Marc-André LeBlanc
Gatineau, Canada
2. The second category has been steadily growing—positive guys. We have discussions about treatment, viral load, STIs and decide how to proceed from there. Sometimes without condoms.
3. The third category is basically everyone else—HIV unknown or undisclosed, and HIV-negative men I don’t know well. I consider guys from this third category as potentially being in the acute infection phase, whether they know it or not. This is the category of men with whom I am most adamant about condom use. All too often, their prevention strategy is dubious at best (e.g., “r u clean? how big r u? wanna bb?”). If I see another highly stigmatizing "disease free"/"no poz" message on an online profile, meant to be some kind of stand-alone, ill-informed HIV prevention strategy, I might reach through the screen and cyber-throttle someone.
So gradually, I’ve found myself feeling much less worried about having condomless sex with a positive guy after a conversation with him about treatment and viral load and STIs than about having condomless sex with a guy who says he is negative, but could be in the acute infection phase with sky-high viral load without even knowing it.
Paranoia? Rational, effective, evidence-based risk-reduction strategy? Both? You be the judge.
But let’s be honest. I also started “slipping up” more and more often because, well… sex feels better without condoms. *gasp* That’s right folks. Sex without condoms feels freaking amazing. You heard it here first.
So while I still maintained a relatively high rate of condom use, I found myself having condomless sex every once in a while. Of course, I also know how effective inconsistent condom use is over time (i.e., not very). 
I like to think I understand the consequences and the stakes. Yes, people living with HV are doing much better today. But I saw my dad die of AIDS in front of my eyes. I saw countless other friends, colleagues and clients become HIV-positive or die of AIDS. That leaves an impression, to say the least.
I like to think I’m a responsible person. I get tested frequently. I stay informed.
I like to think I have high self-efficacy. I have several years of experience using condoms consistently, and I am more often than not the one wearing the condom, so little to no negotiation is required.
I’m not depressed. I never drink. I don’t so drugs. My judgement is not clouded by any of those.
I’m not in denial. I know that the combination of inconsistent condom use, multiple partners, history of STIs and having partners of a different/unknown HIV status is a very strong predictor of seroconversion over the course of a few years.
If all of this doesn’t make me an ideal candidate for consistent condom use, I don’t know what more it would take, short of using Super Glue to permanently bond a condom to Mr. Happy.
Yet here I am.
So as a smart, responsible, well-informed, sexually active gay man with good self-efficacy and good access to healthcare and accurate information, I’ve come to the conclusion that PrEP makes sense for me at this point in my life. I don’t know how long this new “PrEP phase” will last. But I am glad it is available to me while I need it.
***
There are a million other things I have to say about PrEP. Well OK, maybe only half a million. But luckily others have already addressed many of them, and have done it so eloquently. I encourage everyone to check out the following remarkable first-person accounts:
• Len Tooley did a series of interviews on PositiveLite.
• Jake Sobo has been writing a whole series of articles on his blog, “My Life on PrEP”.
• Several other first-person accounts can be found right here on the “My PrEP Experience” blog.
Len and Jake are so friggin’ smart and insightful and articulate, I want to marry both of them. It has been a tremendous source of help and support to read the thoughts of everyone who shared their stories publicly. A big hairy thanks to Jim Pickett for starting the “My PrEP Experience” blog because he recognized that amidst all the heated debates and discussions and policy decisions about PrEP, we weren’t hearing the voices of real-life flesh-and-blood people actually using PrEP.
Gatineau, Canada
• Multiple sex partners? Check
• History of STIs? Check
• Partners of unknown or HIV-positive status? Check
• Inconsistent condom use? Check
• History of STIs? Check
• Partners of unknown or HIV-positive status? Check
• Inconsistent condom use? Check
This is the second installment of a three-part series.
Click here to read the first installment. Click here for Part 3.
Click here to read the first installment. Click here for Part 3.
On April 5, 2013 I took my first dose of Truvada as pre-exposure prophylaxis (PrEP). How did I end up in this situation where I feel like I need PrEP?
As I mentioned in my previous post, a look back at the phases of my sex life gave me some clues about why PrEP makes sense for me now. After more than 20 years of being sexually active, I only recently found myself veering away from perfect 100% condom use.
How did that happen?
Ironically, this is in part because I’ve been working in HIV for 20 years, including the last 10 years focussed on tracking biomedical HIV prevention research. I know what the research is telling us about HIV transmission. I know what proportion of new infections is driven by people who are undiagnosed. I know what undetectable viral load means for transmission risk.
I started serosorting, but not in the conventional sense. More and more, I’ve been dividing guys up into 3 categories.
1. The first category is small. With HIV-negative guys I know and completely trust, we arrive at a form of negotiated safety—if we have been tested for HIV and all STIs recently, and not yet had sex with others, we usually have condomless sex.
As I mentioned in my previous post, a look back at the phases of my sex life gave me some clues about why PrEP makes sense for me now. After more than 20 years of being sexually active, I only recently found myself veering away from perfect 100% condom use.
How did that happen?
Ironically, this is in part because I’ve been working in HIV for 20 years, including the last 10 years focussed on tracking biomedical HIV prevention research. I know what the research is telling us about HIV transmission. I know what proportion of new infections is driven by people who are undiagnosed. I know what undetectable viral load means for transmission risk.
I started serosorting, but not in the conventional sense. More and more, I’ve been dividing guys up into 3 categories.
1. The first category is small. With HIV-negative guys I know and completely trust, we arrive at a form of negotiated safety—if we have been tested for HIV and all STIs recently, and not yet had sex with others, we usually have condomless sex.
2. The second category has been steadily growing—positive guys. We have discussions about treatment, viral load, STIs and decide how to proceed from there. Sometimes without condoms.
3. The third category is basically everyone else—HIV unknown or undisclosed, and HIV-negative men I don’t know well. I consider guys from this third category as potentially being in the acute infection phase, whether they know it or not. This is the category of men with whom I am most adamant about condom use. All too often, their prevention strategy is dubious at best (e.g., “r u clean? how big r u? wanna bb?”). If I see another highly stigmatizing "disease free"/"no poz" message on an online profile, meant to be some kind of stand-alone, ill-informed HIV prevention strategy, I might reach through the screen and cyber-throttle someone.
So gradually, I’ve found myself feeling much less worried about having condomless sex with a positive guy after a conversation with him about treatment and viral load and STIs than about having condomless sex with a guy who says he is negative, but could be in the acute infection phase with sky-high viral load without even knowing it.
Paranoia? Rational, effective, evidence-based risk-reduction strategy? Both? You be the judge.
But let’s be honest. I also started “slipping up” more and more often because, well… sex feels better without condoms. *gasp* That’s right folks. Sex without condoms feels freaking amazing. You heard it here first.
So while I still maintained a relatively high rate of condom use, I found myself having condomless sex every once in a while. Of course, I also know how effective inconsistent condom use is over time (i.e., not very).
An illuminating peek inside the Little Black Book
Three years ago, I started to keep track of my sexual encounters in a proverbial little black book. (OK fine, it’s blue and has a Global Campaign for Microbicides logo and a Rectal Pride for Microbicides sticker on it. It’s super pretty and seemed appropriate). Every time I have sex, I write down what we did, what I know about my sex partner’s HIV status, and whether or not we use condoms. Yup, every time for 3 years. I do this partly so I have very accurate information at my fingertips to relay when I get tested for HIV and STIs. Partly so I have very accurate information at my fingertips when I start to worry. I can look at my list since my last tests and say: look, you had this many encounters, this is what you did with whom, this is how often you used condoms, and this is what you know about his HIV status. Sometimes that helps alleviate the occasional panic attack and insomnia. Sometimes.
I had never seen myself as being “high risk” for the first 20+ years of my sex life. But I’ve been working in HIV for 20 years. So I know the behavioural characteristics of “those people” at high risk. Armed with about 3 years of hard data about my own newly evolving behaviour (i.e., my stylish little blue book), I decided to look at it objectively.
• Multiple sex partners? Check
• History of STIs? Check
• Partners of unknown or HIV-positive status? Check
• Inconsistent condom use? Check
Well then. It’s hard to ignore what this spells.
I like to think I’m at least moderately intelligent. I know how HIV is transmitted. I know how effective condoms are.
Three years ago, I started to keep track of my sexual encounters in a proverbial little black book. (OK fine, it’s blue and has a Global Campaign for Microbicides logo and a Rectal Pride for Microbicides sticker on it. It’s super pretty and seemed appropriate). Every time I have sex, I write down what we did, what I know about my sex partner’s HIV status, and whether or not we use condoms. Yup, every time for 3 years. I do this partly so I have very accurate information at my fingertips to relay when I get tested for HIV and STIs. Partly so I have very accurate information at my fingertips when I start to worry. I can look at my list since my last tests and say: look, you had this many encounters, this is what you did with whom, this is how often you used condoms, and this is what you know about his HIV status. Sometimes that helps alleviate the occasional panic attack and insomnia. Sometimes.
I had never seen myself as being “high risk” for the first 20+ years of my sex life. But I’ve been working in HIV for 20 years. So I know the behavioural characteristics of “those people” at high risk. Armed with about 3 years of hard data about my own newly evolving behaviour (i.e., my stylish little blue book), I decided to look at it objectively.
• Multiple sex partners? Check
• History of STIs? Check
• Partners of unknown or HIV-positive status? Check
• Inconsistent condom use? Check
Well then. It’s hard to ignore what this spells.
I like to think I’m at least moderately intelligent. I know how HIV is transmitted. I know how effective condoms are.
I like to think I understand the consequences and the stakes. Yes, people living with HV are doing much better today. But I saw my dad die of AIDS in front of my eyes. I saw countless other friends, colleagues and clients become HIV-positive or die of AIDS. That leaves an impression, to say the least.
I like to think I’m a responsible person. I get tested frequently. I stay informed.
I like to think I have high self-efficacy. I have several years of experience using condoms consistently, and I am more often than not the one wearing the condom, so little to no negotiation is required.
I’m not depressed. I never drink. I don’t so drugs. My judgement is not clouded by any of those.
I’m not in denial. I know that the combination of inconsistent condom use, multiple partners, history of STIs and having partners of a different/unknown HIV status is a very strong predictor of seroconversion over the course of a few years.
If all of this doesn’t make me an ideal candidate for consistent condom use, I don’t know what more it would take, short of using Super Glue to permanently bond a condom to Mr. Happy.
Yet here I am.
So as a smart, responsible, well-informed, sexually active gay man with good self-efficacy and good access to healthcare and accurate information, I’ve come to the conclusion that PrEP makes sense for me at this point in my life. I don’t know how long this new “PrEP phase” will last. But I am glad it is available to me while I need it.
***
There are a million other things I have to say about PrEP. Well OK, maybe only half a million. But luckily others have already addressed many of them, and have done it so eloquently. I encourage everyone to check out the following remarkable first-person accounts:
• Len Tooley did a series of interviews on PositiveLite.
• Jake Sobo has been writing a whole series of articles on his blog, “My Life on PrEP”.
• Several other first-person accounts can be found right here on the “My PrEP Experience” blog.
Len and Jake are so friggin’ smart and insightful and articulate, I want to marry both of them. It has been a tremendous source of help and support to read the thoughts of everyone who shared their stories publicly. A big hairy thanks to Jim Pickett for starting the “My PrEP Experience” blog because he recognized that amidst all the heated debates and discussions and policy decisions about PrEP, we weren’t hearing the voices of real-life flesh-and-blood people actually using PrEP.
Kamis, 23 April 2015
Anon in Connecticut: "My fear before was being fed by all the misinformation on the internet."
Just got my first bottle of Truvada thru my insurance... I feel protected and liberated.
by Anon
Hamden, Connecticut
Just got my first bottle of Truvada thru my insurance. My copay was only $20.
I should have done this a long time ago. It took me 1 yr to decide to go to my specialist who removed all my fears about side effects. He wasn't concerned at all that there will be side effects since he has many patients taking it for several years.
My fear before was being fed by all the misinformation on the internet, unfounded half truths, and I was stupid enough to listen to those fears and in the meantime I know I could have become HIV+ while waiting and waiting to make that decision to start protecting myself...
Now I have this pill in my hand, I feel so relieved, I feel protected and liberated. Of course, I still plan to use condoms... but we have to be realistic...
When we fall in love.. we do get carried away... that's where this pill comes in for protection.
[EDITOR: If you have a personal PrEP experience you would like to share, send it to myprepexperience@gmail.com. Words or video.]
by Anon
Hamden, Connecticut
Just got my first bottle of Truvada thru my insurance. My copay was only $20.
I should have done this a long time ago. It took me 1 yr to decide to go to my specialist who removed all my fears about side effects. He wasn't concerned at all that there will be side effects since he has many patients taking it for several years.
My fear before was being fed by all the misinformation on the internet, unfounded half truths, and I was stupid enough to listen to those fears and in the meantime I know I could have become HIV+ while waiting and waiting to make that decision to start protecting myself...
Now I have this pill in my hand, I feel so relieved, I feel protected and liberated. Of course, I still plan to use condoms... but we have to be realistic...
When we fall in love.. we do get carried away... that's where this pill comes in for protection.
[EDITOR: If you have a personal PrEP experience you would like to share, send it to myprepexperience@gmail.com. Words or video.]
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