TRUVADA: Why are we ALL not taking this???!!!!

[MrBest]

^ Craigslist. It's still a great place to find some very well known TS porn stars. So is facebook!

whats the point of promoting safer sex if you engage in these activities

[Westheangelino]

whats the point of promoting safer sex if you engage in these activities

To end HIV. DUH

[trish]

Such confidence with other people's lives! Don't you ever worry that perhaps your advice might get a lot of people incurably sick? A true believer is conscious-free.

[lifeisfiction]

Such confidence with other people's lives! Don't you ever worry that perhaps your advice might get a lot of people incurably sick? A true believer is conscious-free.

Truer words were never spoken.

[Westheangelino]

Such confidence with other people's lives! Don't you ever worry that perhaps your advice might get a lot of people incurably sick? A true believer is conscious-free.

No, I don't think that at all. I look at the failures of the anti-HIV community (as valiant as they are) and see 50k new infections a year in the USA. There is no way Truvada can make this worse. BUT we can end this by 2020. The only people with blood on their hands are people like the AHF who are spreading nonsense about Truvada in favor of the tried and true condom only approach.

[trish]

But you tell people that with PrEP's they can throw their condoms away. Really? You've seen the charts showing the probability of infection against exposure on PrEP alone and on PrEP + Condoms. Yet your confidence with other people's lives remains undaunted. Incredible!

[lifeisfiction]

People like yourself West do not want to use condoms. How can it be effective if people similar to you are willing to forgo the necessary protection provided. Condoms work, but it is those who have disdain for it or feel that is its too cumbersome or impractical to use that increases the risk of getting and spreading the disease. If the average user of condoms was rapidly getting HIV due to its failure then you would be correct. The majority of people who are obtaining HIV through sexual activity are engaging in high risk sexual activities. Activities such as bareback sex.

Remember Truvada is not magical blue pill. Even in its own studies the majority of people failed to take the proper dosage. There is a strong chance people who really on this pill will forget to take it. And unlike condoms that is effective on purchase. The dosage of Truvada in the blood stream has to be maintained.

Look at me rehashing what has been said before.

People please use common sense.

[Westheangelino]

People, please use common sense. Get on Truvada and use it. The end.

Trish, your graphs are BULLSHIT

[RobynBlakeTS]

People, please use common sense. Get on Truvada and use it. The end.

Trish, your graphs are BULLSHIT

Ahhh foul language, the refuge of the scoundrel and the classic defence of ignorance when battled with science and knowledge, classy.

Common sense would be condoms + truvada, simples.

A big thank you from me to all the people that have contributed to this topic. I know it can be boring and repetitive arguing with someone who wont listen but it has to be done to ensure people dont listen to him and put their sexual health and the communities and their life at risk for a bit of increased pleasure. Well done to all who have fought the good fight against crazy selfish hedonistic fuck society as a large its all about me me me and my pleasure West.

[trish]

Trish, your graphs are BULLSHIT

Good, then you can tell me exactly where my calculations go wrong. To make it easy for you I'll give you my sources and I'll make a complete list of my underlying assumptions:

1) Sources: one CDC chart, one CDC outreach page

http://www.cdc.gov/hiv/policies/law/risk.html
http://www.cdc.gov/hiv/basics/prep.html

the NCBI publication
http://www.ncbi.nlm.nih.gov/pubmed/9141163

and five Assumptions:

2) The probability of HIV transmission via one exposure of a type that carries R risk per ten thousand exposures is simply equal to R/10000; i.e. R is simply the expected number of transmissions out of 10000 exposures. So when the chart says that 138 is the risk out of ten thousand unprotected exposures to receptive anal intercourse with an HIV infected partner, then the probability of transmission through one such exposure is 138/10000.

3) The effectiveness of a preventative strategy is the percentage by which it lowers the risk. (This definition is inherent in the second link above wherein we’re informed “In several studies of PrEP, the risk of getting HIV infection was much lower—up to 92% lower—for those who took the medicines consistently than for those who didn’t take the medicines.”)
So if p is the probability of transmission through one unprotected exposure (of a specified type) with an HIV infected partner, and if E is the effectiveness of a particular preventative measure (usually expressed as a percent), then P=p-(E/100)*p is the probability of transmission using that particular measure via one exposure.

4) If PrEP and used in conjunction with Condoms, then the probability of no transmission via one exposure (of a specified type) is the product of the probability that there is no transmission using PrEP alone with the probability of no transmission using a Condom alone; i.e. transmission requires the simultaneous independent failure of both preventative measures.

5) Transmission over a run of N exposures is a sequence of N independent events. So if P is the probability of acquiring an infection through one exposure (of a given type and using a specified strategy of prevention) with an HIV infected partner, then the probability Q no transmission through that one exposure is 1-P. The probability of no transmission after a run of N exposures is Q to the Nth power (denoted by Q^N). The the probability of at least on transmission after N exposures is 1-Q^N, equivalently 1-(1-P)^N.

6) The rest is arithmetic, which I assume I did correctly.

I think the take away moral of the this model is how well condoms amplify the effectiveness of a PrEP. The amplification effect is not an artifact of the particular numbers used but is stable; e.g. even if PrEP were 99% effective and condoms only 90% effective, the charts wouldn't look all that different qualitatively.

It would be helpful to the discussion, if you specify which of these items each of your criticisms is addressing.