Category: HIV Info

Feedback

Interestingly enough, I got a ton of feedback from my PrEP post. Mostly in private though. .People reached out to me by email, pvt messages, and even texts to share their thoughts. Most were supportive and a few who disagreed in varying degrees.

I was just struck how so few people were willing to go on the record, so to speak, about the decision. The general consensus I got was that it was a very personal decision and many didn’t feel it should be up for debate by others. This in itself was a bit encouraging. It means people are ignoring the stupidity over ‘shaming’ and making informed decisions about what is best for them. The flip side, in an age where a complete stranger will show you vividly detailed pictures of his anatomy before even meeting, it isn’t so easy to discuss HIV prevention. We have some work to do. If we are ever truly going to get a handle on this we have to let go of the blame and guilt so common associated with STDs in general.

One dissenter was particularly focused on the drug companies making a huge sum of money off of PrEP. I’m not one for conspiracy theories but I also understand greed. But ‘knowing’ something w/o facts or proof isn’t really knowing at all. And frankly the drug companies don’t have to push their drugs on the negative folks. They can just as easily depend on the ignorance and fear to keep the transmission rate high and sell it to you when you convert. And since they aren’t the ones behind the idea to use Truvada as PrEP, it is really hard to sell that theory.

Anyway, I was happy to hear from so many who reached out to me. Some thanked me for my insight and discussion. Some lamented an age of ‘whores’, whatever that means. Overall, the general feeling was of acceptance, not as a solution but as a possible solution. The idea is that you consider it if it would be right for you. And many of my readers seemed to approach it from that perspective as well.

PrEP

So I’m diving head first into a topic of news lately regarding PrEP. *This is a bit of a long post today so grab some caffeine*

If you aren’t familiar with the term PrEP, it stands for Pre-Exposure Prophylactic. [1]Not to be confused with PEP, Post Exposure Prophylactic. The same drug is used for both The drug Truvada has been on the market to treat HIV since the late 90’s. It was recently approved to help with the the prevention of HIV transmission for individuals that are HIV negative. This news has been received with some very mixed reviews from within the community and the fight over it rages on.

The disturbing part is not that the decision is contentious but that there have been attempts to silence or shame anyone who has embraced the option. I must say I don’t really understand the latter. Even worse, much of the criticisms are based on ignorance and baseless (so far) assumptions. I get the advice for caution and concern but the level of vitriol and condescending attacks is unnecessary and counter-productive. If you don’t understand something don’t ramble on about how awful it is because ‘you know someone will abuse it.’ As often turns out, you don’t know and that ignorance can cause real harm in this instance. You have zero right to demean anyone who would choose a path that may help prevent them from getting HIV, even if that path doesn’t line up with your personal preferences.

I blame some of it on our conditioning in Western culture to hate our bodies and/or any idea of sex outside of coupling. We are institutionalized from birth on 1man+1women=babies. Well, that social construct doesn’t apply so well for us same-sex lovin’ folks. And having moral apprehension to a method to prevent the transmission of HIV is perfectly fine for yourself. Sex is not dirty, wrong, or shameful. And this continual shame based approach to sexuality is reprehensible. Frankly, it should dispel any remaining allusions that we are in any way unique or more evolved than our straight brethren.

This particular argument isn’t about personal standards. It is about the prevention of HIV transmission. Infections are once again on the rise at an alarming rate. [2]Ironically, many don’t stigmatize the treatment of other STDs, like Gonorrhea or Syphilis, that used to be considered terminal. And while HIV may not be the death sentence it once was, it is still incurable. It is time to branch out and embrace more ways to combat the spread. The ‘you should use a condom’ argument has soundly failed, as evidenced by the continual rise in infections from a generation that missed the mass die-off in the beginning. And why we of all people continue to fall prey to this failed ideology escapes me. The ‘you should’ method has never worked. If it did, we wouldn’t have teen pregnancies, drunk drivers, continued HIV transmission, or even wars for that matter. You are right, people should use a condom. Many do but many more don’t. It is time to fight the transmission from a different angle and from as many angles as we possibly can.

There are some pros and cons to going on PrEP. It isn’t for everyone based on your risk-factors, health, eating/drinking habits, relationship status, etc. If you have questions or concerns, ignore all the hype and drama. Talk to your health care professional about it. At the end of the day, what I or anyone else thinks you should do is irrelevant. You should act to protect yourself and if this would help you, then you should consider it.

*

For my own view, I support the approach to limit the spread based on sound statistical evidence. So far, the studies are showing that PrEP is truly effective in preventing the exposure and spread of infection.

One big argument I hear has been people will use condoms less. Statistically, so far that proves to be inaccurate. Two of the studies (which use blind testing – meaning you never know if you are getting the real drug or a placebo) showed that overall condom use did not decrease. But let us assume for a moment that people did. How many times have you trusted a complete stranger to be honest about their status? And how many times have you engaged in riskier sex based on that belief? The way I see it, we have several scenarios [3]excluding needle sharing where HIV transmission can occur:

Both partner’s know they are neg.
This is a fallacy. You should never assume someone who has sex with others besides you is neg. But let us assume for the moment, both partners think they are neg. You aren’t in a monogamous LTR and you engage in unprotected sex. Not being on PrEP means you are at the highest exposure rate for transmission. Being on PrEP would mean the ratio of transmission is reduced significantly (As much as 95% without a condom according to the efficacy rates of the studies so far).

One partner doesn’t know his status.
I would argue most of new transmissions via sex happen when one partner doesn’t know his status or assumes his status hasn’t changed. Again, if one of you are on PrEP, the exposure rate is reduced significantly.

Only one partner is neg.
Usually this means the poz partner is already on a drug regimen and undetectable. (You should still ask)  Plenty of sero-discordant couples already weren’t using condoms prior to PrEP. In an LTR or not, now the neg partner has an extra layer of protection and assurance he is not at risk. Not only does this reduce the transmission, it also de-stigmatizes the fear that comes from being with a poz person. Knowing you can be with a poz person and not put yourself at risk helps many who want to get past the mental mind-block, overcome their fear, and move forward.

Both partner’s know they are poz.
These are the least of your worries. These guys know their status and sero-sort on purpose. Primarily, to avoid the afore mentioned stigma that comes with being poz. I’d argue the only time this becomes an issue is when you get into assuming again. “We’re barebacking so he must be neg”, meanwhile, the other guy is thinking “We’re barebacking so he must be poz.” Never assume anyone is neg.

So which category do you fit in?

There are some cons and real concerns to consider. The biggest concern so far is the idea that guys will go on it inconsistently and cause resistance. Keep in mind resistance is only relevant if you sero-convert to being positive. Adherence to the daily regimen is key to the drugs efficacy. But think on this for a moment. The drug is already used for post exposure. Say you aren’t being very consistent with taking it daily. Then you have an exposure. How many of you reading this wouldn’t, out of that same fear, start taking it every day after an a possible exposure?

So far, the medical community is much more worried about resistance from folks that are using it as treatment, not preventative care. And let’s be real, people who spend the time, energy, and money to get on it as PrEP aren’t being cavalier. I’d argue they are doing just the opposite. It isn’t just a simple prescription. You have to visit your doc every 3 months, at least for the first year, for regular checkups and blood work. That decreases over time but you see my point. And when has a doc ever given you a prescription with an unlimited refill amount? See, when you think it thru you start unraveling some of the preconceived notions.

Another issue is cost. Fortunately, most large insurers already cover it so if you have insurance, chances are higher they do cover it vs not. I won’t even entertain the conspiracy theories I’m heard on this one.

And then we get to side-effects. The are some rare but sometimes very serious side-effects that can come from long term use of the drug. That again, is why you discuss it with your doctor and get regular blood work. Almost two decades of use show overall it is well tolerated by most. Even still, you are not given a prescription and never return. The hype over some of the more serious side-effects has been quite dazzling. I encourage you to go to WebMD.com and do a search for both Truvada and the little blue pill. [4]I don’t want to attract the bots so I’m not spelling it out. lolol No one is up in arms over the side-effects of the latter, which by definition aren’t much better. You can choose pretty much any drug site of choice to do a comparison.

In the end, you have to decide for yourself if this is right for you. If you are someone who uses a condom without fail (pun intended) then it may not be the choice for you. However, if you find that you aren’t 100% consistent and/or just want an extra layer of protection, then it might be for you. Talk to your doctor. Talk to others who are on it, regardless of their status. Decide for yourself if PrEP would be an additional way to combat the spread of HIV for YOU.

/rant

References

References
↑1 Not to be confused with PEP, Post Exposure Prophylactic. The same drug is used for both
↑2 Ironically, many don’t stigmatize the treatment of other STDs, like Gonorrhea or Syphilis, that used to be considered terminal.
↑3 excluding needle sharing
↑4 I don’t want to attract the bots so I’m not spelling it out. lolol

Reject

After my last rant, I remembered an email a reader had sent me previously about rejection. He basically asked how I handled rejection.

Learning to handle rejection can be a hard lesson in life. I struggled with it a lot as a young man. Not to say I’m immune to it now, because I’m not. Rejection is part of life. There are still times when it stings. You cannot get thru this world w/o facing rejection in some form or fashion. It is how you handle the rejection that defines your character and growth as a man (or woman).

The hardest and often longest struggle is overcoming your own insecurities. This is often a lifetime goal that will probably never go away. It may get better but it’s always there. We all have insecurities. Yes, read it again. We all have insecurities. And we are often hardest on ourselves. I can’t give you any specific answer here. You first have to be objective enough to recognize said insecurities first. Then, and only then can you begin to work on them. But to realize everyone has them goes a long way to help you feel less alone about it.

What you should avoid is going down a path of ‘what’s wrong with me?‘ should you be rejected. Rejection doesn’t mean there is anything wrong with you, it just means there isn’t a match. No one is everyone’s type and vice-versa. In regards to sex or romantic interest, attraction is a two-way street and if it isn’t both ways then rejection is bound to happen. Of course, it stings, especially when it is someone you are really attracted to. But that in no way diminishes who and what you are. I can speak from experience. I used to internalize it something awful. I’d get down on myself assuming I wasn’t handsome enough, hung enough, buff enough, masculine enough, the list goes on and on. The reality often had nothing with what I was projecting.

Case and point, I used to have the hots for this tall older buff guy when I was living in Colorado. In my eyes, he had it all. He was handsome, hung, articulate, and buff. I’d follow him around like a puppy when I saw him at certain “haunts.” He was never rude or mean to me but he made it plain that he wasn’t interested. I was so dejected. To say I beat myself up over it would be an understatement. At it’s worst, my mood would get so bad when I ran into him I’d often leave.

Be it pity or just kindness, he sort of reached out and befriended me. After we became friends I quickly discovered he had a penchant for young, smooth, pretty blond boys. I mean this was pretty much his only attraction range. There was nothing wrong with me, I was simply not his type. As time progressed, I discovered the same insecurities in him that I had. If he got rejected by a point of interest, he would go into a funk no less severe than my own. It was quite an eye-opening experience and was one of the first times I started looking beyond my insecurities to the bigger picture. He also let me know that he did in fact befriend me because I never pushed it too far. He knew I liked him but because I never tried to force myself on him, he appreciated it.

While not every situation will be this cut and dry, that isn’t the point. The point is that you can’t be everyone’s type. And just because someone declines interest doesn’t mean there is anything wrong with you. [1]And frankly any person who would try to indicate it is your fault, isn’t someone you wanna know anyway. And just because you see someone as being ‘the it’, that doesn’t mean they don’t struggle with the very same issues.

References

References
↑1 And frankly any person who would try to indicate it is your fault, isn’t someone you wanna know anyway.

Bareback Banned

*Long rant today. Informative if you care to read, otherwise skip down if you aren’t in a ‘heavy reading’ mood*

A small firestorm was set off yesterday in the twitterverse w/the announcement of IML banning the sale of bareback [1]sex w/o condoms videos in the future. (It would probably help if you read the article before continuing)  You can also read the fallout from Joe.my.god. I bounced it over to him and he posted it as well.

I thought I’d give it a thorough beating here rather than endless broken comments on twitter and elsewhere. Personally, I have mixed views on the decision. While I support the idea, in theory, I honestly don’t see it having any real affect as is on the problem. Educated informed adults watching a fetish barebacking video does not necessarily equate having unsafe sex in person.

Had this decision been part of a broader effort to unite the neg/poz camps thru acceptance and education, I think it might have had much more of an impact. As is, it 1) is divisive thru the prevailing but misguided belief that blame and finger-pointing is productive, 2) fetish’izes (made up word of the day) the taboo further, and 3) caters to the failed idea that censure has ever worked w/human behavior. Sexuality is tied to our base instincts as human beings and has never been as easy as right from wrong. If it were would the Catholic church still be fighting the ‘abstinence only’ fight? Oh yeah, they’re really winning that battle. /sarcasm

As usual, there are several important distinctions overlooked in the often heated battle over barebacking. From my perspective, the good/bad sides of barebacking, seeing boths sides of the issue (neg and poz), societal re-enforcement of conflicting do’s and don’ts, and finally dispelling the myth(s) often propagated thru irrational fear and ignorance. Otherwise, we end up bickering and solving nothing. Meanwhile, HIV continues to rise in the gay community.

Continue reading Bareback Banned

References

References
↑1 sex w/o condoms

In Need

One of my regular reader’s, Rich, is going thru a bad patch right now dealing with a friend who is chronically ill from advanced AIDS.  Whether you read him or not, please take a moment to click over and wish him well. 

If anyone out there has never watched a loved one die from HIV, I envy you.  Most of us have seen it many times over.  The agony, despair, and utter helplessness can be overwhelming. 

There are times when we need to step outside our day-to-day bubble and reach out to someone in need.  This is one of those times. 

Just Wrong

I’m pretty free spirited and lord knows I have an open mind when it comes to sex.  Tonight, I stumbled over a profile on Manhunt I felt crossed the line, even for me.  There are a lot of strange fetishes in the gay community and even more so online.  But there are certain things I can’t and won’t tolerate.

The guy basically started out ranting with claims about being a real man, masculine, blah blah blah.  Nothing new there, pretty much the same boring fodder as usual.  Then he launches into a speech about mind trips, power, and domination.  *yawn* 

Now comes the part that pissed me off.  He is only looking for negative guys he can dominate and attempt to infect.  He goes on to imply it is the only true form of power and control.  Call it a sick neurosis, a inferiority complex, whatever, it’s fucking wrong.

There are a lot of things I will tolerate but I draw the line at deliberately trying to infect people with HIV.  HIV may not be the death sentence in Western culture it used to be but people are still fucking dying.  More disturbing, the rate of infections in younger gays is on the rise again.  To see some sick fuck with a twisted need to satisfy his limp-dick inferiority complex trying to convince people HIV is glamorous is beyond reprehensible. 

I reported his ass to the admins. [1]It takes about 24 hours usually for complaints to be reviewed.  I also added a note if they allow such a profile to exist, they will lose me as a customer.  I didn’t make it as threat but to make a point.  In the event his profile doesn’t get nixed (I think it will), I’ll go one step further and break one of my cardinal rules about privacy.  I’ll post his profile info here and encourage every single reader to email Manhunt to complain. 

*Update* – The profile was removed when I woke up today.

References

References
↑1 It takes about 24 hours usually for complaints to be reviewed.

Confused Again

So I came up with the poll this week after my friend Matthew said he was a bit upset over being turned down by poz guys. He said two different guys he was interested in dating wouldn’t go out w/him because he was negative. I had to ask again as I was sure I misheard what he said. Nope, I heard him correctly. A poz guy wouldn’t go out with him because he was negative. Ironic wouldn’t you say? Being completely flummoxed, I asked one of my long time (20+ years) poz friends and his response, “well, it is just easier to play with someone who is also poz.” Wait, wait….wait just a damn minute. So now the poz community is using the same flawed logic as the negative community? WTF? After all, isn’t that the same excuse an ignorant negative person would use. After he thought about it, “yeah I guess it is.” I just don’t get people sometimes. Someone would have unprotected sex w/a complete stranger because he says he is negative but they won’t have safe sex w/an honest poz guy. Oh yeah, that makes perfect logic to me. NOT!

Frankly, I’d have safe sex with a serodiscordant person before I’d have any kind of sex w/a meth or drug addict. At least w/a serodiscordant person I know where I stand and what I’m protecting myself against. The latter not so much. I could go on and on about the damage meth does to your brain. Simply put, the most apparent symptom is often extreme paranoia. Paranoia that can and often leads to violence. No thank you.

Sadly, even today there is still a lot of ignorance surrounding HIV and how it is spread. Unless you are into some freaky shit, it really just takes a condom and condom-safe lube. Yep, that is all it takes. And, in an age where a plethora of medical knowledge is only a click away, you have no excuse not to know at least the basics.

Stupidity

As I mentioned earlier, Al from Bent Collective wrote an insightful post about HIV and the failed attempts to combat it in this country. A particularly snotty reader w/no balls of his own, wrote a short but insulting post about blame and then attempted to justify his excuse w/an overt assumption that amounts to a lie.

Of course it’s up to the positive guy! If the negative guy doesn’t know, he is innocent- he doesn’t want HIV. It’s a fact there is a large number of gay guys that like to infect. They have parties for it.

You’re standing up for this!

If you read far enough, you’ll see I lost my temper a bit as well. I make no apologies except to the blog owner. Using fear to spread distrust only serves to divide us further. And if you cater such mentality you are definitely reading the wrong blog.

For the record, HIV is relatively hard to catch. Unless you are sharing drug needles or taking it up the butt w/o a condom, your chances are getting it are pretty slim. And for the record again, I do not condone lying. While it may sound reasonable, to say that it is the sole responsibility of the positive person to inform you of their status is folly at best. One, said person may not even know their status. Two, we don’t live in a perfect world. Three, and the most important reason, no one is responsible for your health but you. If you make blind assumptions you move from ignorance into stupidity. If your health is that important to you, are you really going to rely on the honesty of a perfect stranger? It’s all his fault because you were either too afraid or too timid to ask? Sounds like a Ricky Lake episode to me.

Folks I don’t know how much plainer I can say it. If you are negative and want to stay that way use a condom. It really is that simple! After reading this, you no longer have the benefit of claiming ignorance. And if you are still stupid enough to trust your health to a perfect stranger, you can’t claim “innocence” either.

In Passing…

It is with a heavy heart that I announce my friend died today. After almost a month in ICU battling HIV related pneumonia, he succombed to the illness. I’m sure his family can rest easy now knowing their “faggot” of a son is dead. And I hope whatever god they believe in visits the pain of their ignorance on theme twicefold in shame.

I am saddened but I am also happy. Happy that he is free of the pain and anguish. Happy, he’ll never know how his family tried to unplug him and take his belongings before having seen him in the hospital. His parents were family by chance, I was his family by choice. I think I got the better end of the deal. He was a beautiful person inside and out and he will be missed. More importantly, he will be remembered. I do not believe death is the end. Maybe, if I’m lucky, I’ll encounter his soul again someday.

And to anyone who thinks AIDS is just another disease, I am here to tell you how wrong you are. With all our knowledge and all our drugs, HIV is still killing us one by one. It doesn’t care what race, sex, creed or orientation we are. It kills indiscriminately. And as long as we continue to hide behind petty prejudices many more will die. It killed my friend out of ignorance. You see, he didn’t know he was poz. He’d never been tested out of fear and shame. He was taught all his life being gay was shameful and evil. He finally had the courage to come out and live his life openly only to die 6 years later.

I am often ashamed of humanity, today is one of those days.

Stick & Stones Will . . .

I thought I’d talk about something other than myself today. Yeah, I know, there’s a first.

I do keep up my blogroll even though I get behind at times. Some more than others but I usually make it to all about once a week. Lately though, I’ve been reading Steve from Bent Collective a lot. If you aren’t a heavy reader of Bent, you should be. Here you have a man in the prime of his life giving of himself to help others. He traveled half way around the world to the bodunk country of Uzbekistan, easily a third world country, to setup a clinic and care for the ravaged HIV population there. Uzbekistan is only 2 small countries away from Afghanistan. They don’t particularly like us. Of course, being so far away does present some technological issues. Enter his friend Al who often keeps us apprised of Steve’s lastest efforts via the blog.
Continue reading Stick & Stones Will . . .