There’s a lot of conflicting — and downright confusing — information about HIV these days, and yet the ways to prevent it are deceptively simple, and increasingly so. Then there’s the scary, staggering fact: 50,000 new HIV infections every year in the U.S. alone.
What’s a boy to do?
Today, there are new weapons in our arsenal to halt new transmissions, whether you are negative, positive, or don’t even know (quick tip: find out). So let’s get back to some basics — while exploring new strategies that have a real chance of eradicating HIV. You’re welcome to tape this list to your bathroom mirror, guys.
Or to your bedroom ceiling.
How about we take this to the next level?
Our newsletter is like a refreshing cocktail (or mocktail) of LGBTQ+ entertainment and pop culture, served up with a side of eye-candy.
But the most important step of all might simply be the most human: Take care of yourself and your sex partners, no matter how many or few of them you may have.
First, the vocabulary lesson
Let’s not forget that countless gay men are coming out every day, and for them, the HIV landscape is completely new territory. And even for those vets of gay life, there’s plenty of new developments to track. So let’s start by defining terms.
Pre-Exposure Prophylaxis (PrEP) is the most recent and most debated development. It is a pill (Truvada) that has been used for years as a HIV medication, but is also proven to prevent HIV infection when taken regularly by HIV negative people.
Post-Exposure Prophylaxis has been around for years (health care workers taking HIV medications after getting a needle stick by an HIV patient, for instance), but has been terribly under-used by gay men under other circumstances, like when the condom breaks, have been on a bareback binge, or they otherwise are exposed to HIV. Most gay men simply don’t know about the option (it must begin with 72 hours of exposure), and many emergency rooms are not well informed about PEP.
This means that a person with HIV is on successful treatment and the virus is not detectable through a “viral load” test (these tests have become extremely sensitive to locating active virus). Being undetectable is not the same as HIV negative. It means their viral activity is so low it cannot be measured by the most modern means, and is unlikely to be transmitted during sex.
So now that we’re on the same page of this HIV prevention guide, here are five ways to prevent getting or transmitting HIV.
1. Use a condom every time
Talk about old school, right? Except the tricky part of this advice is “every time.” Using condoms inconsistently is a risky endeavor. Though HIV is actually difficult to transmit, sooner or later the odds might catch up with you. So if condoms are your mode of protection, stay vigilant. And keep plenty stocked in the nightstand, along with latex friendly water-based lube.
2. Know who you’re fucking
This might be the hardest advice for the sexually adventurous single man. Sex with strangers definitely has its allure to some of us. But until you know him well — and we’re talking more than his first name and favorite underwear brand — the best policy is to assume he’s poz and act accordingly. Condoms, PrEP, or putting off unprotected anal sex can all make you breathe a little easier.
Speaking of strangers, remember that crystal meth abuse isn’t just bad for your health. It’s also a major contributor to HIV infection. If your hookup is using recreational drugs, chances are his commitment to a healthy lifestyle — or his adherence to HIV medications — is much lower than normal.
3. Face the facts: PrEP works
The verdict is in, men. Truvada as Pre-exposure prophylaxis (PrEP) is an effective way to prevent becoming infected, with efficacy ranging from 70 percent to 100 percent in various studies when the drug regimen is adhered to carefully, although one recent study found perfect efficacy when taken only four times per week. Yes, there are sometimes side effects and it should only be taken under a doctor’s guidance (which offers further benefits to HIV negative men who might not otherwise be getting regular medical care). The debate over whether or not it works is over, but the choice is yours.
New versions of PrEP are also on the way, including other medications which might suit your body better, and an injectable version given every three months is under development.
It’s hardly worth mentioning that a large organization, AIDS Healthcare Foundation (AHF), continues its confounding battle call questioning PrEP. AHF stands virtually alone in this opinion, dismissing the support for PrEP from most every AIDS agency, the CDC, and even the World Health Organization. You may have seen the organization’s new anti-PrEP ad campaign in which it references worst study outcomes, which were largely due to poor adherence by early study participants who weren’t even sure the drug would work. But AHF does have a point: medications only work when you take them, and adherence to regimen’s is often a problem both for poz guys on meds and neg guys on Truvada.
4. If you dig him, get tested together
So the two of you have been getting naked on a regular basis and are wondering what the next step might be. Here is the answer: get tested together. As in, right now. Hear the results of your tests together (if he is unwilling or says he just got tested, you’ve got a problem, sweetheart, no matter how adorable he is). And then respect your new relationship by supporting each other no matter the outcome. He won’t get tested with you if he fears you will abandon him based on the results.
Budding love (or lust) is a wonderful thing, but hear this loud and clear: the biggest threat to seroconversion is from a primary partner (a boyfriend or regular fuck buddy). There’s plenty of reasons. People think they’re negative when they are not, or they are positive and terrified of rejection, living in denial, or just plain lying. For all the talk about gay marriage (and its inference that gays are dying to become monogamous PTA members), nothing protects us better than getting the facts about your partner and staying honest about the parameters of your sex lives.
5. Stay on your meds
Another new reality is that those who are undetectable for at least six months (which suggests they are taking their medications regularly) are unlikely to transmit the virus to their negative partners. This development is nothing short of miraculous, and will hopefully help stem the bigoted notion that guys with HIV are dangerous vectors of disease. You can take this fact at face value, or use condoms as an added measure of protection.
Our sexuality as gay men is a gift and, well, a total blast. We have the potential for more and better sex than anyone on earth. But it’s also our responsibility to help wipe out this virus so the future gay generations can be spared the devastation of older generations of gay men.
The good news is that whether you are on PrEP or taking HIV meds, these amazing new tools, when used strategically in combination, have the potential to significantly lower new infections among gay men and eventually eliminate it altogether. When infections decline, it creates a kind of virtuous cycle where fewer infections mean even fewer infections.
But like any new medical breakthrough, it still depends on human beings being well informed and making good decisions about their health. Have at it, boys.
EdWoody
I still don’t see what is so difficult about using condoms. I have been sexually active for over 20 years, have had probably over a thousand partners of various definitions, and the most I’ve ever had is a case of crabs (which are not transmitted by bodily fluids) because I know how to protect myself. It’s less than a dollar and less than a minute to use them. Is your life not worth that much? Would you really rather put yourself through thousands of dollars of pharmaceuticals and horrendous side effects? It makes no sense to me at all.
Fang
This is so weird: the advertisement in this article (right above #3, which states that PrEP works) is an advertisement from an organisation called “no magic pill” which opposes the use of PrEP as an HIV prevention tool. Queerty, do you have to approve your ads? A little ironic, right?
QJ201
#6 Don’t be a cum addict taking loads from strangers to satisfy your need
Caine
@QJ201: why not?
TrueWords
#7 STOP using drugs that impair your judgement and lessen the effectiveness of PEP/PrEP and other anti viral medications…
SethChase
@Fang: It’s part of the article, visually showing you what they’re talking about. It’s not an actual ad within the article. Geez!
TrueWords
#2 is essential and probably the MOST IMPORTANT in my opinion
If you are hooking up with someone (or just started dating) you must accept that everything that they have shared is garbage…you know NOTHING about that person…you do not know what their health is currently (remember to keep the lights on and inspect the goods carefully before engaging in sex)…therefore you need to protect yourself and not listen to what you want to hear in order to make sex happen…
PozSince1985
@EdWoody: Whether you see the difficulty or not is irreverent. The facts on the ground are that rubbers are only used about 50% of the time. Clearly the “Condoms Only” message hasn’t worked. 50,000 new infections in the US every year prove that fact.
We have more SCREWdrivers in the HIV prevention tool box now. We need to use all of them to get the epidemic under control. While new infections have levelled of in other key risk groups, they continue to grow amongst Gay, Bi, and other Men who have sex with Men.
I’ve always called PEP the lost child of HIV prevention. It features prominently in Australian campaigns, but is almost never mentioned here. Most guys try to use condoms, but have occasional slip ups. That drunk night at the tubs, or group party and play that got out of hand, does not mean you have to live with HIV for the rest of your life. Research, and find out how to access PEP in your community. Find out NOW so you know what to do when you’re all too human, and make a mistake. When that “oops” happens, you need to move fast. You must start PEP within 72 hours — the earlier the better!
Denying the science behind TasP and PrEP is foolish. Both topics feature prominently at most major medical conferences. They work well enough that your own government, the World Health Organization, and UN-AIDS consider them the best tools we’ve got to stop the spread of HIV. The truth is that they work even better than condoms!
The moralizing, slut-shaming, and outright hate levelled at people who choose the new tools must end. The choices those guys make, may not be right for you,but they’re not wrong. Those guys ARE protecting themselves and the broader world. The people damaging our community are those that harangue men who made well researched, scientifically proven, and logical decisions about safety.
@QJ201: That wasn’t an advertisement placed in the middle of Mark’s piece. It should have been placed one paragraph further down. The article discusses AIDS Healthcare Foundation’s opposition to PrEP. The item pictures is just one example of AHF’s attempts sow doubt and mislead the public.
Matt
One of the dumbest articles I ever read. Don’t do anal is the obvious step in HIV prevention in the gay community. Out of the millions of gay men who’ve died or who are living with HIV/AIDS, only a handful have gotten the disease from sexual activities other than anal sex. Pick any random city. They’re doing it to themselves. You can’t convince them otherwise.
http://losangeles.craigslist.org/search/m4m?query=bareback
DonW
Thanks fir this infirmative piece. Queerty, more of this useful coverage, please — the porn stars and celebrities won’t mind sharing a little space.
DonW
@DonW: *Thanks for this informative piece.
Merv
Protecting ourselves is one half of the equation, but since we’re a community that cares about the well being of everyone, let’s not forget about protecting others by having ourselves tested and informing our partners of our status whether they ask or not.
Also, Matt’s suggestion is a great one. It’s unfortunate that it’s not being pushed at all.
tardis
#8 If you’re cheating on your partner and getting banged each night by different dudes, tell your partner…don’t drag him down the rabbit hole, too.
QJ201
#9 If you swallow, you probably won’t get infected. Get fed, not bred.
mhubba
Mark,
You know I love ya. I applaud your efforts to create a balanced summary and think this is brilliantly framed and presented. I admire the courage of anyone who attempts to distill what is an ocean of knowledge and experience into a short list of priorities for gay and bi men.
Unfortunately this piece contains one glaring error:
The statement:
“The Centers for Disease Control (CDC) says that using condoms inconsistently is as dangerous as never using one at all.”
is patently false, linguistically inverted, and seriously misrepresents the research it references.
1. I don’t believe that anyone at the CDC has said any such thing. Ever. I don’t believe they never will.
2. The use of the term “dangerous” as a descriptor when discussing the use of a protective device is inappropriate and bizarre.
Barring the presence of a serious allergy, persons using condoms at whatever level of commitment will always by definition experience some level of protection versus non-use. Always.
There may be some level of use that fails to confer what might be considered significant protection against *HIV* infection over time, but that level hasn’t been clearly defined. Moreover, protection against all of the other, more transmissible sexually transmissions is will be proportionately more significant at a given level.
3. It is true that at a major HIV research conference in 2013, Dawn K Smith of the CDC presented this finding:
————–
In an analysis of at-risk gay and bi men, those who *reported* “sometimes” use of condoms (1-99%) did not acquire significantly fewer HIV infections than those who *reported* “never” use of condoms (0%).
————–
This is a very different premise with very different implications. Dawn acknowledged the intriguing nature of this finding, and said that the CDC would be examining the data in other ways.
It is commonly understood, and Dawn has acknowledged, that the group of individuals *reporting* “always” (100%) use included those who did not actually achieve perfect adherence. Some level of “inconsistent” use obviously confers some level of protection.
The fact that no difference was seen between these two self-report categories in this analysis of this data does not preclude the presence of a difference using different (more stratified) ones and may well be due to limitations of its design.
So, the analysis as presented to date cannot give clear guidance about those *reporting* “sometimes” (1-99%) use. Perhaps the publication, which I understand has been pending for sometime, will provide more insight.
In any case, I think we need to be extremely careful on the one hand about setting what are for many unreachable goals and on the other hand diminishing what may well be real benefits of realistic ones.
Masc Pride
@EdWoody: Agreed. Condoms work fine for responsible people. Plus, I find it hard to believe that guys who are too irresponsible to use rubbers will properly adhere to a daily medication regimen (that they already know they don’t really need). Even the Truvada site says that condoms should still be used with PrEP.
If you really believe in 3 and 5, what’s the point of 1-2 and 4?
DamonLJacobs
Mark S – What a wonderful and informative piece. Your concise and direct clarification of the oftentimes confusing data is refreshing. We have so many ways now to stop the spread of HIV, it is baffling why so many would oppose this unprecedented opportunity. Thank you for helping to provide such important and valuable tools.
Mark
@mhubba: The CDC study is open to interpretation, but I’ve changed the statement to qualify it more carefully.
DonW
@Masc Pride: I don’t agree that guys who are “irresponsible” about condoms can’t be trusted to take PrEP. It’s a lot easier to develop a routine of taking a pill every morning when you brush your teeth — sober and not turned on except perhaps for morning wood — than it is to correctly, consistently use condoms in the heat of the moment.
Bromancer7
@EdWoody: If you can’t feel a thing and can’t enjoy sex while wearing one, then what’s the point? They might work great for you, but they don’t work great for everyone.
Stache99
Why is there always a contingent that feel the need to lecture. Yes condoms work but people want choices. Great informative article.
Bauhaus
@Bromancer7: You said: If you can’t feel a thing and can’t enjoy sex while wearing one, then what’s the point? They might work great for you, but they don’t work great for everyone.
Well, condoms do work great for everyone, minus an allergy, it’s just that for some reason or another, people will find an excuse to not use them.
If you can’t feel a thing and don’t enjoy sex while wearing condoms, then engage in some other kind of sexual activity.
And just because you don’t feel a thing and can’t enjoy sex while wearing one, doesn’t mean your partner doesn’t feel a thing and can’t enjoy sex while you’re wearing one.
Bromancer7
@Bauhaus: Well that’s great for him, but I’d like to enjoy sex too thank you very much.
So, according to you, I should just never fuck again. Well sorry, but that’s not going to happen.
I love these self-righteous assholes who feel it’s their duty to tell others what they can and cannot do in their own bedrooms.
Condoms do NOT work great for everyone. If they did we’d all be wearing them and there would be no new HIV infections. Clearly that’s not the case, so obviously I’m not the only one who chooses not to wear one whenever possible.
Not getting enough sensation to achieve orgasm or maintain an erection is not an excuse. It is the truth. Why don’t you go spray half a can of desensitizer on your dick before you fuck so you can’t feel anything and then get back to me on how great you made your partner feel and how it was a-ok you felt nothing. Idiot.
Brian
Great article.
Personal anecdote: I used Truvada without side effects. Taken with food, without food, (with alcohol is even OK, doctors say so), and never felt anything. If you have insurance, it’s a smart choice.
Realityis
I am someone living with the harsh realities of living with the side effects of HIV drugs. Side effects that don’t go away and that no one seems to give a shit about anymore. Believe me, no one should ever have to live with lipodystrophy. It’s stigmatizing and the prejudice is seen in both the gay and straight community. I also want to note that I didn’t see the first signs until a few years after being on the meds.
Now I am not saying Truvada isn’t necessarily a good thing, but these arguments I read on this subject literally piss me off. To me, this is a way for the Big Pharma to become even richer off of the HIV negative population. Why, when we know condoms are an effective method of HIV prevention, does anyone want to take medications that could possible fuck up their lives? I don’t understand it at all.
And why doesn’t Big Pharma care about those of us who have lost so much to this devastating side effect? Where is the research and time being spent to finding out what causes this? Obviously if “today’s meds” don’t cause lipodystropy, then they know what was wrong wit the “older meds”. So why make some of us live like this.
It’s all disgusting to me.
DonW
@Realityis: I’m sorry for what you’ve gone through with lipodystrophy and other side effects, but I’m not sure I understand what you’re saying about Big Pharma. Are you arguing that, because they were later able to make drugs without that particular side effect, they must have known how to do so all along but didn’t care? You realize better than anyone that these meds, side effects and all, saved countless lives. Would you have preferred that they didn’t introduce them at all until all the side effects were eliminated?
vive
@Pozsince1985: “I’ve always called PEP the lost child of HIV prevention. It features prominently in Australian campaigns, but is almost never mentioned here.”
I know! PEP information is all over the place in Canada too. I wonder why not here.
vive
@Matt, @Merv, give up anal sex? I don’t think so. Anal sex is what sex is to me – the rest is just foreplay and won’t get me off. How would you feel about giving up YOUR favorite sexual activity?
vive
@Masc Pride. Here is an existence proof invalidating your assertion. I don’t always use condoms but I ALWAYS take my pill.
Realityis
@Donw
I don’t know if they knew or not. Just saying that since they supposedly “figured it out” then their must be at least an iota of knowledge as to how it was caused and how to reverse these side effects. Seems no one is putting the effort into figuring it out tho. And that is what sucks. I really hope that in the next 4 to 6 years we don’t see another outcropping of lipodystrophy happening in the HIV negative community….
NO I wouldn’t have preferred they didn’t introduce the meds, because they have helped me to live a longer life, but after the first 5 or 6 years, prior to the lipodystrophy, the life I am living now is not a lot of fun. Also, I have put out at least 15000 into trying to correct this side-effect of mine.
No HIV negative man can relate to it and I hope they don’t ever have too.
Merv
@vive: If anal sex is important to you, then you should continue. Those who can take it or leave it should be encouraged to leave it.
gaypalmsprings
I am a #truvadawhore. It is a fair statement to say that the use of condoms in Palm Springs is less than stellar. I can have great sex with Truvada – and no, I have not mutated into a creature with 3 eyes and 2 penises. Nor has my skin turned blue. Slut-shaming does nothing to protect yourself or others. If you want to use condoms only, just realize that they are not 100% safe.
tardis
@gaypalmsprings: Jesus.
joey
@Bromancer7: wow this bb sex must feel REALLY REALLY good that someone would need put their life on the line just so he can cum with his dick inside someones ass instead of outside of it….HUGE DIFFERENCE…definately worth risking a life for….DUH!
Bauhaus
@Bromancer7:
You said: So, according to you, I should just never f*ck again.
No, I didn’t say that. I did say to engage in less risky activity. If you want to f*ck without a condom, go ahead.
You said: I love these self-righteous a**holes who feel it’s their duty to tell others what they can and cannot do in their own bedrooms.
Nobody told you what you can and cannot do in your own bedroom. Do what you want. I did point out that condoms work. They are effective.
You said: Condoms do NOT work great for everyone. If they did we’d all be wearing them and there would be no new HIV infections.
Actually, condoms are the most effective tool to date against the spread of HIV, if they are used. The problem seems to be not using them, for whatever reason.
I agree that condoms suck! They can diminish the overall sexual experience. However, HIV is preventable with the use of a condom. It’s your best bet. That’s just the reality of it.
Bauhaus
@Bromancer7: I take it back. I do think you should never f*ck again. You sound like a selfish pr*ck, irresponsible and reckless.
Oh, you sound like a lousy lay, too!
TheNewEnergyDude
@Bromancer7: there are many different types of condoms. Have you tried different ones?
At the very least, if you are not using condoms (even tho I think the whole “they do not work for everyone” is an excuse, I *do* hope you are taking Prep or Pep.
Anyone who willingly wants to do bareback and not protect themselves and the guy they are with deserve a punch in the face. Or ten.
DonW
@Realityis: I can’t relate personally but I can certainly empathize. I have friends dealing with lipodystrophy and I know it sucks. However I’m not sure it’s relevant to the conversation about PrEP or other future anti-HIV measures, unless there is real evidence that the current meds, which have nothing chemically in common with the previous generation, can cause this particular side effect. The possibility of preventing infections is too important to scare people off unnecessarily.
etseq
Overall good article but lay off the hyperbolic invocation of “Science” as some absolute infallible arbiter when making prescriptive claims about the efficacy of PrEP. Using words like denialism implies that there is some equivalency with the very preliminary efficacy trials conducted by a drug company with very little FDA oversight and decades worth of empirical and theoretical evidence supporting evolution and climate change. PrEP is one option for a subset of gay men who are at high risk and who cannot or will not practice safe sex or otherwise reduce their risk of exposure. The CDC makes it recommendations based in many factors and in emergency situations like this often relies on very preliminary scientific evidence out of necessity. Its most zealous evangelists may ultimately undermine its use and effectiveness by blurring sound public health information with their ideological and moralistic crusade for a return to some mythical, idealized pre-AIDS “golden age” bareback utopia. Barebacking is not the sine qua non of gay liberation and calling out those who recklessly glamorize and promote it is NOT slut-shaming or sex negativity.
buffnightwing
@etseq: Barebacking is not the sine qua non of gay liberation and calling out those who recklessly glamorize and promote it is NOT slut-shaming or sex negativity.
YOU mean SEX? Jesus Christ. Grow up. It’s people having sex. You make it sound like they are robbing banks.
buffnightwing
Every time an article talks about barebacking, or as I like to call it, sex, the usual naysayers and slut shakers always arrive on que. Don’t do this, don’t do that. I’ve been negative 30 years, blah, blah, blah.
Bauhaus
@buffnightwing:
Yes, barebacking is sex, the part of sex that transmits HIV.
Being a grown-up is taking responsibility for having safe-sex.
There is no slut shaming about having responsible sex and condom use.
buffnightwing
@Bauhaus: and he proves my point! ROFL
Stache99
@Daniel-Reader: Someone complaining of loss of sensation is common. If you put a layer of plastic on top of your skin of coarse you’ll have a huge loss of sensation. It’s rare that a guy can take it to the end as in orgasm too.
buffnightwing
@Bauhaus: The people that really need to hear all of this, of course are NOT on this website. LOL
anyway, THANK YOU for proving my point. I’m guessing you are over forty with your screename.
queerT
You say it’s simple and proceed to lay out complicated, impercise, confusing and frankly ineffective methods. You yourself have made note of how half of HIV infections are from someone’s primary partner so WTH does “know who you’re fucking” have to do with anything?It is actually way more simple than 5 steps. Keep cum and precum out of your ass (and mouth if you have open sores). That’s it! I have never in my life met a gay man who didn’t get HIV from having bareback sex. Supposedly you can get it from oral if you have sores in your mouth but I have never met anyone who did and I’d be suspicious of anyone claiming it.
Bromancer7
@Bauhaus: See, the part you don’t understand is that for some people condom use is a minor “diminishing”, but for guys like me it’s a complete “diminishing” which makes the act completely without pleasure.
So save your fucking platitudes and self-righteousness. Yeah, condoms work great at preventing the spread of disease, *IF* you can wear them and still function. I cannot, ergo, they do not work for me. Why is this so difficult for people like you to understand.
It’s fascinating, because if condoms were a drug, and the side effect was complete loss of sensation and inability to achieve orgasm people would be screaming left and right about how horrible a drug it was and that no one should take it. But if it’s a condom, oh, well they’re great, and if you don’t feel a thing, well, too bad, do something else then. Bullshit.
Bromancer7
@Bauhaus: 27 years of bareback sex and I’m still negative. And there is no shortage of guys willing to have sex with me. I’d say I must be doing something right.
Tired old queen, find someone else to troll.
Bromancer7
@joey: Don’t knock it till you try it.
Bromancer7
@TheNewEnergyDude: Yes, I have tried many different brands and styles, and spent a small fortune doing so only to end up with a drawer full of condoms that will never get used. I need a large size so my options are even more limited. Regular, thin, extra sensitive… they all feel the same, as in, nothing.
Bauhaus
@Bromancer7:
So, you think you’ve spent a small fortune on condoms…
Just think what you can spend if you get HIV or some other STD/STI.
I’m finished with you. Your brain feels nothing, just like your limp d*ck feels nothing.
Daniel-Reader
Should be going to a doctor to address the progressive spinal nerve damage if you cannot feel anything wearing a condom.
Also, need to get message out better to gay/bi/closeted men of color in the USA because infection rates are off the charts.
Merv
@Bromancer7: Did you try female condoms?
onthemark
@buffnightwing: Well, you keep changing your story here (i.e. lying) about whether you’re actually negative or positive, so we’re not sure where you’re cumming from.
TheNewEnergyDude
Bromancer7 said…
“27 years of bareback sex and I’m still negative. And there is no shortage of guys willing to have sex with me. I’d say I must be doing something right.”
You are just lucky. Because you’re certainly NOT doing something right. Who cares how long you’ve been acting like a stupid, selfish person. What…you want a medal??
Good luck to you when you *do* get it and get to the point where you are table to control your bowels and have to deal with the multitudes of lord knows what side effects.
“Tired old queen, find someone else to troll.”
Maybe he gives a crap about yours and others welfare. But why should he gie a crap when you and the other skanks you screw don’t even have the common decency and respect for themselves.
vive
I can relate to the problems with loss of sensation with condoms, and statistics on condom use show that a lot of guys, maybe even a majority, agree with this.
Realityis
@DonW: However I’m not sure it’s relevant to the conversation about PrEP or other future anti-HIV measures, unless there is real evidence that the current meds, which have nothing chemically in common with the previous generation, can cause this particular side effect.
This is what I am talking about, and it doesn’t have to be the side effect that I am talking about. I don’t think we know the possible long term side effects. Pharmaceutical companies have a way of expediting drug trials so they can get their drugs on the market. The negative community is a new and untapped market. Hell, I am sure doctors also profit in some way. And all I am saying is I don’t wish anyone the life I have right now. That’s all. I’d give anything to be negative and using condoms right now. I live in NYC and I taught fitness for years. Now I barely walk into a gym…. just saying.
vive
@Bauhaus, We have to stop pathologizing condomless sex, also formerly known as sex (as buffnightwing pointed out).
It took me a long time to go to a doctor to ask for PrEP. Do you know why? Because I was ashamed to tell him I don’t use condoms all the time. Instead, I was having a really bad time dealing with a bunch of unnecessary psychological issues (why am I being so self-destructive blah blah blah) that nobody should have to go through for just having what used to be called just regular sex, and in the meantime I was at risk because I could not ask for PrEP. I did go the ER for PEP (the month-long post-exposure regimen) a couple of times, but I was also ashamed to go ask for PEP again every time I needed it, again because I had internalized the slut-shaming attitudes towards what you call “barebacking” that you seem to be promoting.
PrEP is good. Condoms are good. Why do we have to turn everything into a fight?
buffnightwing
@onthemark: I am HIV positive. I take Truvada as part of my regimen.
JEEZ LOUISE.
As if it’s any of YOUR business anyway, douchbage.
Bromancer7
@TheNewEnergyDude: Yeah, not going to happen. I’m going to the grave HIV-. But thanks for the well wishes.
And I’m sure Bauhaus has someone’s best interests in mind when he attempts to slut-shame them or tell them to just suck it up and never enjoy sex again — so long as you keep that condom on. Uh-huh. Nope, sounds like another judgemental queen to me.
Bromancer7
@Daniel-Reader: There’s nothing wrong with my nerves, but thanks for the armchair diagnosis.
And even if there were, nerve damage is not reversible and it would still mean that I would be unable to wear condoms and enjoy sex. Sooo…
Bromancer7
@Bauhaus: And that, my bitter friend, is why I have really good health insurance.
Bromancer7
@Merv: I have, and they’re really not any better. Most guys find the inner ring to be uncomfortable, so it usually has to be taken out. And without the ring to hold it in place it basically turns into a very loose regular condom that makes a lot of scrunching noises.
If the bottom can tolerate the ring being left in it’s better, still noisy as hell, but I’m very restricted as to how deep I can go as they aren’t very long. So if they want all of me, they’re not going to get it. Which makes them want to take the ring out and I’m back at square 1.
I’ve just started experimenting with the Fort Troff Raw Dawg XL, and it might turn out to be a good alternative, provided the bottom doesn’t freak out about it.
DonW
@Realityis: I’m really sorry for what you’ve gone through. I agree that we don’t know the long-term side effects of Truvada as PrEP, though there are quite a few years of experience of HIV+ people taking it.
Yes, the drug companies rush trials through (though to be fair, it was activism by ACT-UP etc. back in the ’80s that made fast-track approvals possible). No, I don’t think doctors are prescribing this stuff to make money. If anything, most doctors are quite resistant to the idea.
I have no love lost for Big Pharma, but a lot of other people (including you, I gather) are alive today because of it.
Matt
@vive: Vive, anal sex isn’t really sex. It’s just a filthy act that’s killed so many gay men and put so many on meds for the rest of their lives. Prior to the 1960’s anal was rarely practiced in the gay community. Now look where we are at. It’s not a good place to be. Gay men are the laughing stock of the world because they can’t prevent themselves from getting this most preventable disease.
Stache99
@Matt:Interesting that you went back to the 60’s to get your statistics. Seems you picked that because there’s no videos as proof.
In other parts of the world it’s hetero problem and no one’s laughing about that. Plus, every straight video has at least one anal scene in it. Clearly it’s popular across the board.
Matt
Vive said, “give up anal sex? I don’t think so. Anal sex is what sex is to me – the rest is just foreplay and won’t get me off”
That’s your problem Vive and those like you. You think because straights have vaginal intercourse you must copy and do your version of it. You keep infecting each other with something you consider sex. Straights do anal too, but click my link for more info. It’s not happening to them at the high rates of gay men. You guys don’t love or even like each other when you keep infecting one another.
Stache99
@Matt: Last question is what are you even doing here? You use the words “you guys” and you seem to only pop up in these kind of discussions.
Paco
@Matt: In my 30 years of being sexually active, I have yet to encounter (in the flesh) a gay man that didn’t expect anal sex. The “no anal” gays must be a very rare breed. Your sex shaming doesn’t help anything.
Merv
Oral isn’t the only alternative to anal. There’s also intercrural (between the thighs) and frot (penis to penis).
queerT
What’s funny about this POS is that he and his ilk are always nonsensically crying “sex shaming!” “slut shaming” at people who are doing nothing of the sort. Then you read number 2 and its ALL ABOUT slut shaming and making judgements about drug users. Get your story straight. The “condom nazis” as you so kindly call us, say you can sex with whoever you want, whenever you want and as many times as you want. Who’s the real slut shamer?
Stache99
@queerT: What a sad troll you are. Obviously you don’t give a sh*t about this subject because that’s exactly not what he said or meant.
CCTR
Thanks queerty good article, but as usual many of the comments stink!
buffnightwing
@CCTR: This is the discussion. I told my Nurse about it the other day. I said GAY MEN ONLINE are shaming and stigmatizing other gay men for wanting to use the PILL. PREP! It’s just like when birth control came out.
The comments get personal because these guys have no real defense against saving lives.
buffnightwing
@Matt: Talk about self hating. You see guys what the Tea Party mentality does to people. They hate themselves and the people around them.
I just feel sad for your pathetic little troll life.
buffnightwing
@CCTR: Queerty could do a better job of deleting personal attacks, but since they don’t, I feel I need to defend myself.
Bromancer7
@Merv: And tittie fucking is an alternative to vaginal intercourse, but do you really expect straight men to give up pussy in favor of it? I don’t think so.
Bromancer7
@Matt: You’re deranged. Please get help.
DonW
I used to have these kinds of emotional reactions about PrEP when I first heard about it — we’ve all be raised on fear and shame about gay sex. So I read as much objective material as I could, AND (crucially) talked to guys who are actually taking it. They’re not heedless sex fiends. They are thoughtful, honest guys concerned about their own health and that of their partners.
I am happy to join their ranks. UPS is delivering my presciption today.
CCTR
@buffnightwing: I agree some of the personal attacks and middle school antics should be deleted as they do nothing to promote any type of meaningful discussion.
It is obvious that many of the PrEP haters are unable to accept the fact that some people that choose to have condom-less anal sex can still do it in a responsible way…responsible meaning using alternatives to condoms as a form of HIV prevention. “Responsible” does not exclusively mean using a condom.
So much of the attacks are really prudish judgements on consenting adult’s individual sexual expressions, fetishes, and desires, when really the attack should be on the virus and finding a complete cure. It’s those moralistic judgmental attitudes that cause people to be too ashamed to discuss, disclose, get tested, be prepared with condoms, or speak with health care professionals about PrEP or PEP…just my opinion
CCTR
@buffnightwing: “It’s just like when birth control came out.”
Yep anything having to do with sexuality quickly becomes polarizing and controversial. Most are not being judged for taking high blood pressure meds, high cholesterol meds, and daily aspirin (all of which have costs and side effects) to prevent stroke and heart attack even as research has shown often times dietary and exercise changes can be just as effective for many.
It shouldn’t be so difficult for folks to accept differences in personal choices. Different things effectively work for different people.
Bauhaus
@Vive:
Your comment to me was heartfelt.
Make no mistake, PrEP is not a substitute for condom use. PrEP should be used with condoms, and/or less risky sexual sexual behaviors, such as oral sex.
Is your health important to you? If it is, there can be no shame in asking your health care provider for the tools to better take care of and protect yourself. If you don’t feel completely comfortable with your health care practitioner, find one you do feel comfortable with. Ask around for a gay/gay friendly health practitioner.
How is responsible sex, taking care of yourself and your partner, sex shaming? Barebacking, I suppose, has become a porn industry term. You wouldn’t go to your doctor and ask for PrEP, because you are barebacking, just like a woman wouldn’t ask her doctor for the Pill, because she is f*ck*ng.
We know that condoms are the most effective method against the transmission of HIV, HEP C, herpes, syphilis, gonorrhea, and genital warts. PrEp does nothing to prevent other STD/STI’s. Moreover, PrEp is prescribed to be used in conjunction with condoms, not as the sole prophylactic.
Education is not shaming. Surely, if you have a prescription for PrEP, it must have been explained by your practitioner, that it should be used together with a condom. Every time. That’s using PrEP as prescribed. There is nothing shameful or shaming about properly using PrEP, condoms, safer sex, or making healthy decisions .
So, PrEp is good. Condoms are good, as you said. They are even better when used in conjunction, every time. The only fight we should be having is the one to keep all of us safe and healthy.
Of course, the article is about how to help end new HIV infections, not about making lame excuses for not using condoms, and the dubious claim of remaining HIV negative for decades. Not your claim, I know.
Here is the government link on PrEP: http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/pre-exposure-prophylaxis/
Bauhaus
@CCTR:
PrEP is not an alternative to condom use. Period.
PrEP is not prescribed to use so people can engage in sex without condoms.
Educate yourself.
http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/pre-exposure-prophylaxis/
Paco
I don’t understand all the self-righteous preaching going on about how others are choosing to deal with sex and HIV. I’m sure the people who have chosen to use PrEP have already had the necessary discussions with their prescribing physician on proper use and possible side effects without all the moral finger wagging. If PrEP isn’t for you, then fine, go use your condoms or limit your sex to body rubbing and be happy about your choice.
As more people begin to use PrEP, it will be interesting to see some of the real world data on its effectiveness without condoms. Until then, I think we should sit back and wait how things fare for the men and women who have chosen to use PrEP as their preferred form of protection against HIV and keep the judgements to ourselves.
CCTR
@Bauhaus: I have educated myself and I am aware of how PrEP is prescribed, but in real world settings theory doesn’t equate to reality.
Don’t you think the way it is prescribed has more to do with the position of responsibility of any authoritative bodies (CDC, doctors, researchers etc.). They would be deemed irresponsible to not promote condom use which has been proven to be very effective in stopping the transmission of HIV.
To think that PrEP was developed and is being prescribed with the expectation that is will solely be a supplement to condom use is being a little naive and unrealistic. Condoms are highly effective and many people choose not to use them, then PrEP becomes their line of defense against the virus, isn’t that more likely the basis behind prescribing and using PrEP? I could be wrong but just my thoughts.
joey
@Bromancer7: let me tell you how terrified i am of gettings aids, i could never bb the thought of bb, even when i might see itin porn makes my dick go limp, all i see is aids and disease. about two years ago i began to realize how many guys were lying or just had no idea, that and a few other “scares” just had me give up fucking altogether. yes it sucks and at times i miss it but you know what i dont have to get tested, sit there waiting for results or deal with liars or guys that have no idea. while i ALWAYS used condoms, shit still happens, i might not be as sexually active but i dont have to worry about it anymore.
vive
@joey, at one point I was living my life that way too. I decided it was, for me, a sad and wasteful way of existing. It took time but I got over it.
If even fucking WITH condoms gives you anxiety, what about using condoms AND PrEP? That way you have the bases covered and your chance of getting anything would be pretty much zero.
Bauhaus
@CCTR:
Many couples choose to use PrEP when one is HIV positive and the other is negative. Often, when anal sex is involved, even with a condom, there is fear of condom breakage, or there may be actual breakage. If there is exposure to the negative parter, he must go on PEP, if he’s not already on PrEP.
So, PrEP gives the negative partner added protection and peace of mind, while continuing to engage in sex with a condom.
For single folks with multiple partners, it’s the same thing. If you’re single and negative, being on PrEP and using a condom every time will greatly reduce your chance of acquiring HIV.
Because condoms can break, slip, or fail in some capacity during sexual activity, PrEP can pick up when condoms don’t do the job properly.
Now, I won’t even pretend to know what they had in mind when PrEp was developed. All I know is that it is prescribed to be used with a condom. A condom every time.
Michael Lucas glamorizes this trend of using PrEP in lieu of condoms. Just because he does it, doesn’t mean it’s safe and that it should become mainstream.
vive
@Bauhaus, yes, condoms plus PrEP is safest, but it is already mainstream to forego condoms, and PrEP alone is better than nothing. A survey not long ago in London, U.K., found some crazy number (something like 90%) of gay guys didn’t use condoms with all their casual partners, while surveys in the U.S. found large numbers (I forget, but something like 60% or 70%) of gay guys forego condoms with casual partners at least some of the time. In the small city in the Northeast where I live, almost no guy I meet who is under 35 will suggest condoms when I meet them – things have changed a lot since I was their age and using condoms was standard. Now they might ask your status and perhaps ask you to pull out before you cum, but that’s the extent of their precautions.
As for safety, there is still more research to be done, but there are already estimates available to the effect that using PrEP consistently (on its own) is comparable in efficacy to using condoms consistently, and may even be superior in efficacy.
Bauhaus
@vive:
Perhaps that’s why there are 50,000 new cases of HIV diagnosed each year in the United Sates alone.
Misinformation, apathy, lack of HIV education, better HIV treatment, I can’t even guess the reasons people have for not properly protecting themselves.
But just because people are doing it, and it has become mainstream, doesn’t mean it is safe. Look at the new infection rates every year in the U.S., and also look at the age group most likely to test positive.
What study do you know that demonstrates PrEP use alone is as effective or superior to condom use? Also, PrEP will not protect against any other STD/STI.
I am a PrEP advocate, but only as it is prescribed, which is with a condom.
CCTR
@Bauhaus: Thanks for your response. I do agree with and understand your scenarios but I’m not sure that you are looking at this in a realistic way but we are all rightfully entitled to our opinions, understanding and interpretations.
Think outside of theory, PC language, homophobia, and sex shame and the role of the CDC and related agencies to advocate less risk and more protection period. It would be very difficult for them to tell, particularly gay men that they can significantly reduce their risk for HIV transmission by adhering to taking PrEP even if they choose to forego using condoms for anal intercourse. I wouldn’t be surprised if that that of dialogue goes on in private between health care professionals and those inquiring about PrEP.
Is the efficacy research and studies of PrEP based solely on PrEP being used with condoms? It would not be considered a “powerful HIV prevention tool on it’s own” if it had to be used with a condom to be effective. My point is despite the way it is being prescribed the research and efficacy that have been made public give people information to make a choice. I don’t advocate PrEP over condoms but for those that are not using condoms I think PrEP alone is certainly a prevention tool.
Trying to make people use condoms every time all the time even when access is there has proven to be impossible. A “powerful prevention tool” is better than no prevention tool… and that’s all I have to say on the subject… for now
Bromancer7
@CCTR: Um, the CDC disagrees with you http://www.cdc.gov/hiv/prevention/research/prep/
While they suggest condom use in conjunction with PrEP they make it clear that it is not mandatory, nor designed to be used that way. It is merely a suggestion.
Bromancer7
@Bromancer7: Damn, that was supposed to be a response to Dr. Bauhaus, who is wrong on just about every facet of PrEP.
Bauhaus
Dr. Anthony Fauci, who has headed the National Institute of Allergy and Infectious Diseases since 1984 and was one of the leading researchers involved in developing antiretroviral therapy for H.I.V., has perhaps found the best way to split the difference. Dr. Fauci told me PrEP is “highly efficacious, in my mind easily over 90 percent if you adhere rigidly to it,” without specifically citing the 99 percent figure. He was quick to add, in line with the guidelines from all the United States government agencies encouraging the use of Truvada as a preventive measure, that it’s meant to augment the protection provided by condoms, not to replace them.
From and article about Truvada. Josh Barro, New York Times.
buffnightwing
@Bauhaus: We are talking about KIDS here. OK? What part of that don’t you get? 13 to 24 is KIDS. Kids don’t think, they ACT. How long has it been since you were 17?
Yeah, I thought so.
Your arguments make no sense in light of the fact that NO ONE is using CONDOMS.
buffnightwing
@Bauhaus: Are YOU a Doctor? Do YOU live in the REAL world?
Stop with the condom shouting already. No ONE is using them.
What makes you an so called expert on all this? These kids need good support and guidance, and YOUR shouting about condoms, DOESN’T WORK.
But, I’m sure you’ll keep shouting.
buffnightwing
When STRAIGHT people go on birth control (women on the pill) the don’t use condoms. They could get STI’s and HIV and all that other stuff, but I don’t see some of you all on here screaming at them to USE CONDOMS. LOL
The hypocrisy in here is stifling.
queerT
@buffnightwing: Yes they do and straight people aren’t the high risk group. They don’t have anonymous sex with hundred of different partners.
http://m.dailylife.com.au/life-and-love/love,-sex-and-relationships/has-the-pill-become-passe-20140911-3fdme.html
vive
@buffnightwing, true, but we should at the same time be informing gay men that they HAVE to get vaccinated against Hepatitis B and HPV (genital warts) – by the way, condoms are not that effective in preventing HPV infection, making this even more urgent. Condoms are not great at protecting against HSV either. The other common STIs (e.g., syphilis) are easily cured but should be screened for – they can for the most part be transmitted orally and NOBODY uses condoms for oral.
Matt
@Paco: You can’t be serious. lol You obviously hang around with the wrong people.
Matt
@Stache99: do you know many straight people who are Hiv+ ?
Matt
@Stache99: http://www.man2manalliance.org/crw/frot/whatis.html
Paco
@Matt: Completely serious. Wrong people? Nope, don’t think so.
queerT
@buffnightwing: PrEP has been out 2 years. There are only 1k Rxs for men. 80% of gay men are neg. Do the math. People are using condoms. Maybe no poz guys like you are. If your poz why don’t you sit down and STFU about prevention.YOU FAILED. No one in their right mind would listen to you or King.
queerT
Oh and great job all you gay barebackers.You’ve brought syphilis back from near nonexistence. This is great PR for gay rights. You just prove the worst stereotypes about gay men.
http://m.smh.com.au/national/health/venereal-disease-mystery-as-syphilis-hits-record-high-20140917-10iaar.html
Realityis
Nice compassion there QT…..
I met a guy, fell in love, he lied to me and because of that I have lived with the hell of being HIV + for 20 years. The body fat side effects have been a nightmare alone. And that is really all the complications I have had. But that one thing is devastating.
Personally, I don’t understand why a negative person would want to take meds that are comparable to chemo. What a shock it would be if we see a new generation of lipodystrophy in the next 5-10 years. Wouldn’t that be a hoot. What if Truvada actually will cause it in 5-10 years. Then what? A big OPP’s from the Pharmas and their lobbyists? Disgusting.
I started taking the medications cus I wanted to live. Unfortunately “no one” knew about the side effects they caused. I didn’t see anything for the first 4-5 years and then it hit me all at once.
Putting this out there to make people think twice, and if that’s a scare tactic, so be it.
Realityis
Oh and what is with this “My Fabulous Disease”. More like “My Horrible Disease”.
vive
@Realityis, Truvada is not comparable to chemo.
vive
This keeps being autofiltered – not sure which word it is so sorry for the word surgery:
@Realityis, regarding lip@dystrophy, while the causes are not understood, it appears to be mostly associated with pr@tease inhibit@rs (which are in @HAART c@cktails but not in Truv@da by itself) as well as possibly the older @NRTIs (specifically @A.Z.T. and Z@rit), which Truvada does not contain either. HIV itself is also thought to be a contributing cause.
This makes lip@dystrophy in HIV- people on Truv@da quite unlikely. Also, if even the slightest changes are observed, Truv@da can be stopped right away (excepting any very recent possible exp@sure to HIV, in which case it has to be continued for some weeks AFAIK) and the dr@g is eliminated from the body in a few days.
Realityis
From the Truvada website: (See #3)
Serious side effects of TRUVADA may also include:
New or worsening kidney problems, including kidney failure. Your healthcare provider may do blood tests to check your kidneys before and during treatment with TRUVADA. If you develop kidney problems, your healthcare provider may tell you to take TRUVADA less often, or to stop taking TRUVADA.
Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones.
Changes in body fat can happen in people taking HIV-1 medicines.
Changes in your immune system. If you have HIV-1 infection and start taking HIV-1 medicines, your immune system may get stronger and begin to fight infections. This may cause minor symptoms such as fever, but can also lead to serious problems. Tell your healthcare provider if you have any new symptoms after you start taking TRUVADA.
DonW
For Healthcare Professionals
Applies to aspirin: compounding powder, oral delayed release capsule, oral delayed release tablet, oral gum, oral powder for reconstitution, oral tablet, oral tablet chewable, oral tablet disintegrating, oral tablet dispersible, oral tablet extended release, rectal suppository
Gastrointestinal
Endoscopically identifiable gastric mucosal lesions occur in most patients who receive a single dose of aspirin (the active ingredient contained in Bayer Aspirin) Clinically evident gastrointestinal bleeding has been reported in as many as 3% of treated elderly patients. Anorectal ulceration and rectal stenosis have been reported in patients who abuse aspirin-containing rectal suppositories. One case-controlled study has suggested that an association between aspirin (and other NSAID) consumption and appendicitis may exist.
The risk of developing dyspeptic events (i.e., epigastric pain, heartburn, nausea, ulcers) is low in rheumatic patients with no prior gastrointestinal symptoms who receive low-dose (less than 650 mg/day) aspirin therapy.
Gastrointestinal side effects have included epigastric distress (in as many as 83% of patients treated with regular aspirin), abdominal discomfort or pain, endoscopically identifiable gastric mucosal lesions, nausea, and vomiting. More serious gastrointestinal effects include hemorrhage, peptic ulcers, perforation, small bowel enteropathy, and esophageal ulcerations.
Renal
The mechanism of an aspirin-induced decrease in renal function may be related to inhibition of renal prostaglandin synthesis with consequent decreases in renal blood flow. Vasodilating renal prostaglandins may be particularly important in patients who exhibit arterial underfilling (i.e. heart failure, cirrhosis). The administration of high doses of NSAIDs to such patients has produced acute renal failure in rare instances.
Renal side effects have included reduction in glomerular filtration rate (particularly in patients who are sodium restricted or who exhibit diminished effective arterial blood volume, such as patients with advanced heart failure or cirrhosis), interstitial nephritis, papillary necrosis, elevations in serum creatinine, elevations in blood urea nitrogen, proteinuria, hematuria, and renal failure.
Hematologic
Hematologic side effects have included increased blood fibrinolytic activity. In addition, hypoprothrombinemia, thrombocytopenia, thrombocyturia, megaloblastic anemia, and pancytopenia have been reported rarely. Aplastic anemia and eosinophilia have also been reported.
Hypersensitivity
Hypersensitivity side effects have included bronchospasm, rhinitis, conjunctivitis, urticaria, angioedema, and anaphylaxis. Approximately 10% to 30% of asthmatics are aspirin-sensitive (with the clinical triad of aspirin (the active ingredient contained in Bayer Aspirin) sensitivity, bronchial asthma, and nasal polyps).
The mechanism of aspirin-induced hypersensitivity may be related to an up-regulation of the 5-lipoxygenase pathway of arachidonic acid metabolism with a resulting increase in the products of 5-lipoxygenase (such as leukotrienes).
Dermatologic
Dermatologic side effects have included Stevens-Johnson syndrome and a lichenoid eruption. In addition, isolated cases of unilateral aquagenic wrinkling of the palms and papuloerythroderma have been associated with aspirin (the active ingredient contained in Bayer Aspirin) therapy.
Hepatic
Hepatic side effects have included hepatotoxicity and cholestatic hepatitis.
Oncologic
Oncologic side effects have included reports of pancreatic cancer. Several epidemiologic studies have suggested that chronic aspirin (the active ingredient contained in Bayer Aspirin) use may decrease the risk of large bowel neoplasms. However, other studies have not found such a beneficial effect.
Metabolic
Metabolic side effects have included dehydration and hyperkalemia. Respiratory alkalosis and metabolic acidosis, particularly during salicylate toxicity, have been reported. A case of hypoglycemia has been reported in a patient on hemodialysis. Salicylates have also been reported to displace triiodothyronine (T3) and thyroxine (T4) from protein binding sites. The initial effect is an increase in serum free T4 concentrations.
Cardiovascular
A 29-year-old female with a history of migraine developed chest pain, tachycardia and orthopnea following aspirin (the active ingredient contained in Bayer Aspirin) consumption at doses of 1500 mg per day for several days. After discontinuation of aspirin therapy, the patient’s symptoms promptly resolved. The patient consented to a pharmacological challenge test which once again triggered the symptoms.
Cardiovascular side effects have included salicylate-induced variant angina, ventricular ectopy, conduction abnormalities, and hypotension, particularly during salicylate toxicity. In addition, at least one case of fluid retention simulating acute congestive heart failure has been reported during aspirin therapy. Antiplatelet therapy has also been associated with acute deterioration of intracerebral hemorrhage.
Nervous system
Central nervous system side effects have included agitation, cerebral edema, coma, confusion, dizziness, headache, cranial hemorrhage, lethargy and seizures. Tinnitus and subjective hearing loss (or both) may occur. Some investigators have reported that modest doses may result in decreased frequency selectivity and may therefore impair hearing performance, particularly in the setting of background noise.
Some investigators have suggested that tinnitus may be a less reliable indicator of salicylate toxicity than previously believed. Patients with high frequency hearing loss may have difficulty perceiving tinnitus. In a study of rheumatoid arthritis patients, those with tinnitus had no greater salicylate levels than those without tinnitus. Elderly patients may be less likely to perceive tinnitus than younger patients.
Other
Reye’s syndrome typically involves vomiting, neurologic dysfunction, and hepatic dysfunction during or shortly after an acute viral infection.
Other side effects have included Reye’s syndrome with aspirin use in children with an acute viral illness. Reye’s syndrome has also been reported even more rarely in adults.
Musculoskeletal
Musculoskeletal side effects have included rhabdomyolysis.
Respiratory
Respiratory side effects have included hyperpnea, pulmonary edema, and tachypnea.
Aspirin desensitization has been used to decrease disease activity and reduce the need for systemic corticosteroids in patients with aspirin-exacerbated respiratory disease.
Endocrine
Endocrine side effects have included hypoglycemia (which has been reported in children) and hyperglycemia.
Ocular
Ocular side effects have included cases of localized periorbital edema.
up, scary potential side effects. Now this, from the Bayer Aspirin website:
DonW
@DonW: Sorry, my previous post deleted my introductory line. In reply to @Realityis:
Yup, scary potential side effects. Now this, from the Bayer Aspirin website:
Matt
@Paco: That is so sad. Seriously. I’m glad I never became a gay stereotype and part of the buttf**k dictatorship. It’s really a filthy way to live your lives: douching, enemas, condoms or not, HIV tests, HIV scares, bleeding, feces, the internal problems of bottom bois, testing poz, slow death, and now truvada. It’s hard to believe gay men would actually take truvada so they can have raw buttsex. That is one crazy sickness. No wonder why straight people still laugh at the gay community. The things they do in the name of sex is downright ridiculous. Billions of people all over the world take aspirin and are fine. You can’t compare the two drugs.
http://www.man2manalliance.org/crw/frot/dictator.html
DonW
@Matt: Really? “Filthy?” “Sickness?” Your obsession with dirty, bad, icky buttsex puts you more in line with Tony Perkins and Pat Robertson than any gay liberationist. You might as well throw in some references to the fictional “Gay Bowel Syndrome” they like to dredge up.
Your “Frotman” links are, umm, eccentric. What’s your success rate at convincing people to change their sexual behavior? That’s never worked for the Bible thumpers, why would it work for you? Do you have any hard evidence whatsoever that the incidence of anal sex has changed markedly over time?
Look, the human sex drive causes people to do lots of things, and perhaps the world would be tidier if they didn’t do some of them. Both you and the scared-of-sex Right need to get this through your skulls: It Is Going To Happen Anyway. No one is going to make you participate. So just try not to let it keep you awake at night.
Realityis
@DonW: Look. Take the medication. I hope and wish nothing but the best for you.
I am only trying to make people aware of the devastating side effect known as lipodystropy, which according to the Truvada website, can happen. Believe me, it’s something you don’t want. It has devastated my social life and self esteem, as well as, countless others who suffer from it. The gay community views it the same way the straight community does. Not a lot of compassion there.
Lipodystrophy is non-treatable right now and research for a cure has all but halted. I have spent thousands trying to correct it.
I really hope it works without the side effects, but again, we need a cure. We need to stop making Big Pharma richer at our expense.
DonW
@Realityis: I really do feel for you and for my friends who live with lipodystrophy. Truvada just doesn’t seem to pose a significant risk, even though Gilead has to cover their rear by listing every conceivable side effect, however unlikely.
I did not make the decision to go on PrEP lightly. I have read just about every piece of research out there, talked to people with first-hand experience, and consulted extensively with my doctor. I am tired of hearing not only of young guys getting infected, but also of men in their 40s and 50s who, after managing to avoid the virus for decades, are newly HIV+ and devastated. So I’m adding another element of safety along with condoms.
Like you, I desperately want this epidemic to be over. Taking PrEP is my small contribution toward that goal. I’m vigilant and informed about potential side effects, but if this prevents me from becoming another statistic then it is worth it.
Stache99
@Matt: It’s hard to believe women would actually take birth control so they can have raw sex. That is one crazy sickness. No wonder gay people still laugh at the straight community. The things they do in the name of sex is downright ridiculous.
? Increased risk of cervical and breast cancers
? Increased risk of heart attack and stroke
? Migraines
? Higher blood pressure
? Gall bladder disease
? Infertility
? Benign liver tumors
? Decreased bone density
? Yeast overgrowth and infection
? Increased risk of blood clotting
Paco
@Matt: I never mentioned aspirin, so I don’t know what you are talking about. If it is about possible side effects, then consider this… A popular blue pill for erectile dysfunction can cause heart attacks, strokes, eye damage and possible damage to your penis if you don’t seek medical attention for an erection lasting more than 4 hours. It is a top selling drug. Are erections worth those risks? They must be. Most drugs have possible serious side effects that may affect only a very small percentage of those that take them, but those side effects must still be reported. Just wait until you have to start taking pills for old age. The side effects listed for them are very scary.
Do us all a favor and leave the prudish, judgemental BS to the right wing Christian a**h0les, because we get enough from them without needing it from our own community too. Get back to me when you have stopped heterosexuals from engaging in anal sex and then we’ll talk. K? Until then, I don’t give a damn what they think of our sexual activities.
(The word filter guessing game is so much fun here.)