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

[Westheangelino]

http://www.latinpost.com/articles/23544/20141012/www-google-com.htm


^Awesome news!

[trish]

If "awesome" means: ALWAYS USE A CONDOM in tandem with any other adopted preventative measures.

[Westheangelino]

^ That's certainly not what I meant ;)

[MrBest]

^ That's certainly not what I meant ;)
why do you hate condoms so much

[Westheangelino]

^ That's like asking why someone hates Diet Coke

[TSMichelleAustin]

Seems like not many people here care but u about this. I dont think it will be as big as u think or wish.

[Westheangelino]

^ Let's revisit this in five years. The fact is most people don't know about it

[lifeisfiction]

I don't get West, if there was an epidemic of condoms being unable to prevent HIV I could understand such a hard push. Condoms have been excellent and if person feels the need to bareback. Then its best in a committed monogamous relationship where both parties have been tested. Other than that this is being pushed for people who have a history of high risk sexual activities. With the side effects being liver damage, why is a person really taking this drug?

That is why Michelle is right, people won't care about it because there is not as much as a need for it as people think there should be one.

[Westheangelino]

^ You can't actually be serious?

50,000 new HIV cases a year. Every year. In the USA. This isn't an epidemic????!!!!!!!!! Are you fucking insane???????????? Condoms, in perfect use, do prevent HIV. We've been at this for 30 years. A condoms only strategy to combating HIV simply DOES NOT WORK. If this drug had come out 20 years ago it would be heralded as a miracle.

You people make me fucking puke. You can choose to continue to live in denial if you want, but what makes me ill is that your Puritanical and unscientific judgmental attitudes are what's keeping more people from knowing about this miracle drug.

[trish]

Truvda, in perfect use, doesn't prevent HIV either. The effectiveness of any preventative measure decreases exponentially over the duration of use. A drug that is 95% effective over one year's time is only 90% effective over a two year period. For a period of twenty years the effectiveness drops to 0.95 to the twentieth power; i.e. 36% effective over a twenty year period. If you're in a long term relationship with a partner who is infected, you'd be a fool not to use every preventative measure at your disposal that doesn't carry the risk of deleterious side-effects with long term use...that means CONDOMS.

[fred41]

I think where this product truly shines, and I believe this has been mentioned in some of the articles,...is in committed relationships where one partner has HIV.
The way I see it, if used with condoms, the negative partner really protects themselves even further...
...but I would understand if, in a long term loving relationship, the negative partner, especially if they were a top (lower risk), would be willing to take a chance with daily use of this pill alone.

[Westheangelino]

Fixed that for you. I bet something develops though- I'll watch the real world trials with interest.

I just can't see going pharmaceutical unless I have to for some reason. Like a "life depends on this" kind of reasons.


Truvda, in perfect use, doesn't prevent HIV either. The effectiveness of any preventative measure decreases exponentially over the duration of use. A drug that is 95% effective over one year's time is only 90% effective over a two year period. For a period of twenty years the effectiveness drops to 0.95 to the twentieth power; i.e. 36% effective over a twenty year period. If you're in a long term relationship with a partner who is infected, you'd be a fool not to use every preventative measure at your disposal that doesn't carry the risk of deleterious side-effects with long term use...that means CONDOMS.

Where are you getting this information???? With perfect use, Truvada is 99% effective. More than condoms when used perfectly, which almost never are used perfectly.

[lifeisfiction]

^ You can't actually be serious?

50,000 new HIV cases a year. Every year. In the USA. This isn't an epidemic????!!!!!!!!! Are you fucking insane???????????? Condoms, in perfect use, do prevent HIV. We've been at this for 30 years. A condoms only strategy to combating HIV simply DOES NOT WORK. If this drug had come out 20 years ago it would be heralded as a miracle.

You people make me fucking puke. You can choose to continue to live in denial if you want, but what makes me ill is that your Puritanical and unscientific judgmental attitudes are what's keeping more people from knowing about this miracle drug.

I don't have to bring up the whole article thing that clearly proved truvada research methods was poor. But show me that most of the HIV causes, wait in fact show me any facts where 10% of the people who have HIV is caused from condom failure when the parties are engaged in protective sexual activity. I am waiting West.

[Westheangelino]

I don't have to bring up the whole article thing that clearly proved truvada research methods was poor. But show me that most of the HIV causes, wait in fact show me any facts where 10% of the people who have HIV is caused from condom failure when the parties are engaged in protective sexual activity. I am waiting West.


And you'll keep waiting. Where are you even getting this 10% number? It's certainly nothing I ever said. "Perfect" use doesn't even mean manufacturing error. It means not using the product as intended, not following directions, or only sometimes using it.


You're all missing the main benefits:

1. The drug, unlike condoms, doesn't reduce sexual pleasure. There are some people, myself included, who have always been willing to negotiate and quantify risk based on the fact that barebacking just feels better. Not saying it isn't risky. It is. But this is reality and will continue to be unless something else comes along.....now it has!

2. There is no heat of the moment mistake. You put a condom on a hard, pulsating cock. You take a truvada in the morning when you brush your teeth. See the difference?

3. The power is solely in the hands of the individual. How many cases of HIV have happened because of peer pressure? Lies? Empty promises? the closet? A LOT.

[MrBest]

you dont want status & BB to be stigmatized/thread

[MrBest]

by the way being poz doesnt mean you cant contract different strains

[lifeisfiction]

And you'll keep waiting. Where are you even getting this 10% number? It's certainly nothing I ever said. "Perfect" use doesn't even mean manufacturing error. It means not using the product as intended, not following directions, or only sometimes using it.


You're all missing the main benefits:

1. The drug, unlike condoms, doesn't reduce sexual pleasure. There are some people, myself included, who have always been willing to negotiate and quantify risk based on the fact that barebacking just feels better. Not saying it isn't risky. It is. But this is reality and will continue to be unless something else comes along.....now it has!

2. There is no heat of the moment mistake. You put a condom on a hard, pulsating cock. You take a truvada in the morning when you brush your teeth. See the difference?

3. The power is solely in the hands of the individual. How many cases of HIV have happened because of peer pressure? Lies? Empty promises? the closet? A LOT.

There it is, you can be safe using condoms.

I know you enjoy bareback sex and like many people they feel condoms break the mood. However, they have proven over the years to provide excellent protection. Of course sex without a condom feels great, but not everyone is willing to risk such a venture. Especially with the scientific study conducted not being really sound.

Many people have a wait and see attitude, because if the drug is less effective than stated the consequences can be bad. Truvada is target at a high risk demographic. I feel the drug is being pushed too hard too fast, particularly as its being marketed as great preventer of HIV without a proper study. For me, I rather see how the drug operates in the actually world then relying on poor studies. If its good, then it provide options in my sex life.

Plus West, I think you are mistaken that the other STDs are nothing to worry about. STD's are becoming more resistant to antibiotics and some of them are very very difficult to cure or are incurable.

Like I said unless you are willing to engage in much more riskier sex, Truvada is not really a concern.

PS: If you are willing to take the risk, be prepared for the consequences.

[lifeisfiction]

by the way being poz doesnt mean you cant contract different strains

Thanks Mr. Best, I forgot people who kept re-infecting themselves with HIV when they thought they could not get it again since they already have it.

[Westheangelino]

There it is, you can be safe using condoms.

I know you enjoy bareback sex and like many people they feel condoms break the mood. However, they have proven over the years to provide excellent protection. Of course sex without a condom feels great, but not everyone is willing to risk such a venture. Especially with the scientific study conducted not being really sound.

Many people have a wait and see attitude, because if the drug is less effective than stated the consequences can be bad. Truvada is target at a high risk demographic. I feel the drug is being pushed too hard too fast, particularly as its being marketed as great preventer of HIV without a proper study. For me, I rather see how the drug operates in the actually world then relying on poor studies. If its good, then it provide options in my sex life.

Plus West, I think you are mistaken that the other STDs are nothing to worry about. STD's are becoming more resistant to antibiotics and some of them are very very difficult to cure or are incurable.

Like I said unless you are willing to engage in much more riskier sex, Truvada is not really a concern.

PS: If you are willing to take the risk, be prepared for the consequences.

50,000 new infections speaks to the failure of condom only campaigns. Of course, I'm not knocking the crusaders of the past. From the early GRID days til the last two years, condoms were the only proven preventative measure. Times change. You wouldn't tell a woman taking the birth control pill to use a diaphram would you?

[lifeisfiction]

When you engage in riskier activity it carries a higher risk. People who contract HIV are engaging in riskier sexual activities. If you want to have bareback sex, then in a monogamous relationship with both parties being tested prior to bareback sexual activity. Its safe. If however you wanted to sleep with multiple partners then its best to minimize the risk, because people lie and are dishonest. A more scary scenario are people who are willing to put other people's health at risk for their own pleasure. I can mention even scarier forms out there. Its best to take the precautions that keep you safe, however if you feel the riskier options provide a fuller sexual experience, just understand what you are engaging in.

If Truvada proves to be true and your only concern is getting HIV then its the drug for you. I do wish you caution, the drug has not been proven to be as effective. In the end only the pharmaceutical company producing it and promoting it doesn't have to live personally the consequence of HIV.

[Westheangelino]

When you engage in riskier activity it carries a higher risk. People who contract HIV are engaging in riskier sexual activities. If you want to have bareback sex, then in a monogamous relationship with both parties being tested prior to bareback sexual activity. Its safe. If however you wanted to sleep with multiple partners then its best to minimize the risk, because people lie and are dishonest. A more scary scenario are people who are willing to put other people's health at risk for their own pleasure. I can mention even scarier forms out there. Its best to take the precautions that keep you safe, however if you feel the riskier options provide a fuller sexual experience, just understand what you are engaging in.

If Truvada proves to be true and your only concern is getting HIV then its the drug for you. I do wish you caution, the drug has not been proven to be as effective. In the end only the pharmaceutical company producing it and promoting it doesn't have to live personally the consequence of HIV.

Nearly everything you just wrote is utter nonsense. You understand that thousands of people contract HIV every year while in "monogamous" relationships right?

Most men don't want monogamous relationships. This is a fact no matter how much the mainstream gay agenda would have the straight world believe otherwise.

You keep saying "if" Truvada proves effective. It IS effective and has been proven so.

Really? People taking it are the only ones who stand to lose if Truvada proves inneffective? (which isn't going to happen anyways) For sake of argument, you don't think that Gilead, the drug's manufacturer, stands to face massive litigation should we see cases of people contracting HIV despite acceptable levels of the drug in their blood? (again, this won't happen, but just sake of argument).

[MrBest]

Nearly everything you just wrote is utter nonsense. You understand that thousands of people contract HIV every year while in "monogamous" relationships right?
dishonesty has nothing to do with it:rolleyes:

[MrBest]

For sake of argument, you don't think that Gilead, the drug's manufacturer, stands to face massive litigation should we see cases of people contracting HIV despite acceptable levels of the drug in their blood? (again, this won't happen, but just sake of argument).
why would they if theyre not marketing their drug like you are

[lifeisfiction]

Nearly everything you just wrote is utter nonsense. You understand that thousands of people contract HIV every year while in "monogamous" relationships right?

Most men don't want monogamous relationships. This is a fact no matter how much the mainstream gay agenda would have the straight world believe otherwise.

You keep saying "if" Truvada proves effective. It IS effective and has been proven so.

Really? People taking it are the only ones who stand to lose if Truvada proves inneffective? (which isn't going to happen anyways) For sake of argument, you don't think that Gilead, the drug's manufacturer, stands to face massive litigation should we see cases of people contracting HIV despite acceptable levels of the drug in their blood? (again, this won't happen, but just sake of argument).

Well if you have to cheat don't take your partner down with you. So men hate monogamous relationships and women love monogamous relationships, well that would explain why I know personally of many married women cheating on their husbands.

If you are in a real monogamous relationship then it shouldn't be a problem. Honestly that is the worst logic I ever heard of to say everyone is cheating so you need to take it.

Lets state it again, you are not going to get HIV if you engage in proper safe sex with no incident. That's not going to happen. All you have done is say that my statement is incorrect on something you personally feel happens with no evidence to back it.

Most people get HIV through sexual contact have engaged in riskier sex. We all know that so its nothing new.

You know my position on this information and again you have never present an argument saying the New York Times article was inaccurate. I read through all the past posts and all the articles where before the NYT article and the one article you placed afterward did not counter the study.

Why would I even spend time arguing because I have seen people suffer from misinformation. West if you feel my argument is invalid, then ignore it. If people want to take the risk I cannot stop them. Sex is grand, but its not worth risking your life over it.

[Westheangelino]

why would they if theyre not marketing their drug like you are

Because they're selling it as HIV prevention and allowing entire states (NY, Michigan, Mass., so far) to recommend it as such. If it actually doesn't prevent HIV.....do the math.

[Westheangelino]

Well if you have to cheat don't take your partner down with you. So men hate monogamous relationships and women love monogamous relationships, well that would explain why I know personally of many married women cheating on their husbands.

If you are in a real monogamous relationship then it shouldn't be a problem. Honestly that is the worst logic I ever heard of to say everyone is cheating so you need to take it.

Lets state it again, you are not going to get HIV if you engage in proper safe sex with no incident. That's not going to happen. All you have done is say that my statement is incorrect on something you personally feel happens with no evidence to back it.

Most people get HIV through sexual contact have engaged in riskier sex. We all know that so its nothing new.

You know my position on this information and again you have never present an argument saying the New York Times article was inaccurate. I read through all the past posts and all the articles where before the NYT article and the one article you placed afterward did not counter the study.

Why would I even spend time arguing because I have seen people suffer from misinformation. West if you feel my argument is invalid, then ignore it. If people want to take the risk I cannot stop them. Sex is grand, but its not worth risking your life over it.


LIES. Go back a few pages. The follow up study came out after that NYT article.

Also, I am NOT proposing that every man, woman, and child take this. Neither do the CDC or WHO. They're saying that all sexually active MSM (men who have sex with men) take it. And, for their purposes that includes Tgirls and their admirers.

I will not be recommending this drug to any of my straight friends. BUT this is not that type of forum.

[lifeisfiction]

If you have the article, then post the link. I want to see which article you have that counters the NYTs article. Don't tell me to go back and read it. Just post it.

[trish]

Where are you getting this information???? With perfect use, Truvada is 99% effective. More than condoms when used perfectly, which almost never are used perfectly.Given 99% effective over a one year period, Truvada is only 82% effective over a twenty year period. Where am I getting this? I'm doing the math. The risk of side-effects also rises exponentially with time of projected use. I'm not saying don't use Truvada. But beware of the risks and use condoms too...unless you don't give a damn about your own health.

Question: Why don't you participate in any of other discussions and threads in these forums? Do you regard yourself as a member of the HA community? What is your real interest here? There's little evidence that you care anything at all about this community and lot's of evidence that you're very interested in pushing Truvada. How much do you get paid?

[Westheangelino]

If you have the article, then post the link. I want to see which article you have that counters the NYTs article. Don't tell me to go back and read it. Just post it.


I'm not going to repost for a THIRD time. I don't have to give citations every time I post something that isn't new. Besides, you're not the person I'm trying to reach. You've clearly made up your mind and will interpret anything I post (even hard, verifiable numbers) to fit your view.

I'm trying to provide information on something that everyone should know about but few people do.

[Westheangelino]

Given 99% effective over a one year period, Truvada is only 82% effective over a twenty year period. Where am I getting this? I'm doing the math. The risk of side-effects also rises exponentially with time of projected use. I'm not saying don't use Truvada. But beware of the risks and use condoms too...unless you don't give a damn about your own health.

Question: Why don't you participate in any of other discussions and threads in these forums? Do you regard yourself as a member of the HA community? What is your real interest here? There's little evidence that you care anything at all about this community and lot's of evidence that you're very interested in pushing Truvada. How much do you get paid?

You clearly don't understand how medications work. If you take lipitor for an extended period of time, your odds of a heart attack don't increase. If you take the birth control pill, your odds of having a baby don't increase over time either.

You do understand that you can search to see any and all posts someone has ever made right? So, go look at mine. I've read this board for over six years. You can imagine how someone will get bored seeing variations of the same exact thread over this time and thus won't comment on them right?

"Am I gay?"
"Who is this girl?"
"Who has the biggest dick?"
"Visting X city...what to do there?"
"Top or bottom?"

^80% of the threads on here are this. Which is totally fine! This is a great place to inform newbies. It just shocked me to learn about the drug myself and shocked me even more that we aren't all shouting off the roof tops about it!

And really? You think I'm getting paid for this? What a horrible marketing strategy that would be! LOL

[lifeisfiction]

I'm not going to repost for a THIRD time. I don't have to give citations every time I post something that isn't new. Besides, you're not the person I'm trying to reach. You've clearly made up your mind and will interpret anything I post (even hard, verifiable numbers) to fit your view.

I'm trying to provide information on something that everyone should know about but few people do.

I have actually read all your articles and no I have never seen one that countered the NYT's article. You keep claiming there is one. If you are referring the article in the advocate, that did not address the issues found in the article.

Trish, I think you're right. Maybe he is getting paid to advertise, lol.

[trish]

If you take lipitor for an extended period of time, your odds of a heart attack don't increase. Of course they do. You can treat each year as an independent event. The risk for each single year is the same as any other year, but if you intend to use it over an extended period of time, the risk is higher for that projected period of use.

If you take the birth control pill, your odds of having a baby don't increase over time either. Yes they do, and for the same reason. If you intend to use the pill for an extended period time, the probability of getting pregnant over that projected period is higher than the probability of getting pregnant say this year if you're on the pill.


You clearly don't understand how medications work.No, you don't understand; and yet you're here giving everyone advice. I wouldn't care if you weren't advising people to be reckless. Nothing wrong with using Truvada and condoms, as long as you're aware of the risks associated with Truvada and keep an eye out for symptoms.


And really? You think I'm getting paid for this? What a horrible marketing strategy that would be!Plenty of people get paid for shilling products on internet forums. You wouldn't be the first.

[Westheangelino]

Of course they do. You can treat each year as an independent event. The risk for each single year is the same as any other year, but if you intend to use it over an extended period of time, the risk is higher for that projected period of use.
Yes they do, and for the same reason. If you intend to use the pill for an extended period time, the probability of getting pregnant over that projected period is higher than the probability of getting pregnant say this year if you're on the pill.

No, you don't understand; and yet you're here giving everyone advice. I wouldn't care if you weren't advising people to be reckless. Nothing wrong with using Truvada and condoms, as long as you're aware of the risks associated with Truvada and keep an eye out for symptoms.

Plenty of people get paid for shilling products on internet forums. You wouldn't be the first.


YOUR CHANCES OF GETTING PREGNANT OVER TIME DO NOT INCREASE WHILE ON THE PILL

Year number five is no different than year number two while on the pill. Stop spouting nonsense.

In any case, these things aren't even comparable! If enough HIV + people are in treatment (and people on ARV treatment do NOT pass on HIV), and enough neg people are on Truvada then we can end HIV as a real risk within the decade. Free your mind. Your ass will follow

[trish]

Of course year five is no different than year two. But what counts is the projected period of use. This is especially true when one's health is at stake. Over a twenty year period Truvada is 82% effective, not 99%.

If Truvada can end HIV as a real risk in a decade, then HIV in tandem with condoms will do even better. Free your mind. Your ass will follow.

[Westheangelino]

Here's a little something to open your eyes.....

http://betablog.org/51-new-hiv-infections-condom-failure-anal-sex-study-finds/

[trish]

Refutes not a thing I've been saying.

[trish]

If everyone (or the vast majority) used Truvada, then more than 50% of all new HIV infections would be the result of the failure of Truvada to prevent the infection. The study merely attests to the popularity of condom use. It also demonstrates the good sense behind not depending on one single kind of preventive measure. Don't just rely on condoms. Likewise, don't just rely on Truvada.

[lifeisfiction]

Here's a little something to open your eyes.....

http://betablog.org/51-new-hiv-infections-condom-failure-anal-sex-study-finds/

I am starting to think you are making money promoting this product. When I read an article I go to the actual study. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0107540

Sometimes I wonder if people actually read what the study says. It is probably guess on limited factors. Its a mathematical model based on the assumption. I don't know if you read any scientific articles before, but you always read how the study is done. They never asked anyone just ran the numbers. Investigative research in the medical field yields the best results. For example http://www.aidsmap.com/Condom-efficacy-in-gay-men/page/1324955/.

At this point, you are going to keep pushing the drug. I pray and hope that I can be wrong, however I suspect I am not about the effectiveness. Like I said this won't be the first time a drug being pushed was as effective as they stated. Yes, they can be sued, but the money made from the drug will cover it.

Look West if you want to gamble on Truvada go ahead. I am not taking a gamble on my life. Truvada with condoms might give a great protection. But I believe through your own statement, you don't have to worry about condoms you really are going to risk heavy. Truvada alone is not good. And we never talked about the side effects.

Anyways, I just wanted to people to be aware of the risk they are taking.

I rather wait and see.

[Westheangelino]

If everyone (or the vast majority) used Truvada, then more than 50% of all new HIV infections would be the result of the failure of Truvada to prevent the infection. The study merely attests to the popularity of condom use. It also demonstrates the good sense behind not depending on one single kind of preventive measure. Don't just rely on condoms. Likewise, don't just rely on Truvada.


I don't even know what that paragraph means. As of now, next to no one is on truvada. This study has nothing to do with it.

[trish]

Let’s take the promotor’s word for it that the effectiveness of Truvada is 99%. This means that if you use the product as directed for a period of one year, then the probability that you will be infected during that period of use is one chance in a hundred; i.e. 1%. Already you can see this is going to vary from individual to individual and region to region because different people are prone to different behaviors and some locales are hotter than others in regards to HIV. But we’ll continue to go with the promotor’s numbers; i.e. 99% effectiveness over a year’s use.

So what then is the probability of getting infected if you intend to use Truvada as directed for a period of five years? Easy. It’s the complement of the probability of not getting infected over that period, which is the product of the probability of not getting infect the first, second, third, fourth and fifth years: i.e. 1 - (.99)(.99)(.99)(.99)(.99) = 0.049. That about a 5% chance.

Okay, so what if you are 30 years old and your life-partner is infected with HIV. You plan to spend your life with this individual. You imagine you might be having sex with him at least into your sixties. So if you use Truvada over the next 30 years as directed, can you calculate now the probability that you’ll get infected at some point within the next thirty years? Yes, you can. It’s just 1-(.99)^30 = 0.26; i.e. a 26% chance. We can say that the effectiveness of Truvada over a 30 year period is 74%. See why you might want to use condoms as a second line of defense?

Suppose you had a revolver with an enormous cylinder that can hold one hundred bullets. Suppose further that all the chambers are empty except one. Each year on your birthday you spin the cylinder, point the pistol at your head and pull the trigger. Each year there’s a 99% probability of surviving your birthday. But if you’re thirty years old, the probability that you’ll live to see sixty is 74%. Wanna play?

Sure you might survive. Suppose there are 100 people who play this game. You might survive the first decade. But somewhere around 9 or 10 of your fellow players won’t. Your probability of surviving the next two decades is about 82%. That’s better than 74% because you already survived one decade and only have two more to go. You might even make it to your fiftieth birthday. If you do you’ll be one of about 82 survivors. Given the fact that you made to your fiftieth birthday, the probability of seeing your sixtieth is now better than 90%. Pretty good. If you make it to your sixtieth birthday you will be one of about 74 survivors. Congratulations. The game is obviously in your favor. But it’s also a game you obviously don’t want to play if you don’t have to. If you do have to (love can make you do many strange things) maybe you want to do something to increase your odds. Plug the barrel of the gun with cement. Turn on the safety and solder it in place. Put a condom over the barrel. Anything.

Yes, yes...the Russian roulette metaphor is a bit harsh because HIV infection is not an immediate death sentence. But that’s beside the point. The probabilities are the point.

Some studies suggest that condom’s alone can be 90% to 95% effective against the spread of HIV infection over a period of one year’s use. Let compromise and say it’s 92.5% effective against the transmission of HIV over one year’s use. It seems likely (to me) that condom failure and “Truvada failure” would be independent events. If so, given that you both use a condom and take Truvada as directed, then the probability of getting infected within one year is (0.075)(0.01) = 0.00075. Hence the effectiveness of the combo is 0.9995 (over a one year period). What’s the probability of getting an infection within the next thirty years if you use the combo? Easy 1-.9995^30 = 0.015. So the probability of not getting infected sometime within the next thirty years is 0.985; i.e. the effectiveness of the combo over a thirty year period is 98.5%.

[broncofan]

I don't even know what that paragraph means. As of now, next to no one is on truvada. This study has nothing to do with it.
What she is saying is that if a lot of people use condoms and some condoms fail then those transmissions will comprise a large percentage of the total transmissions. Let's say 90 out of one hundred people use condoms, and condoms are 90% effective. You would have 9 transmissions from condom use. If unprotected sex resulted in transmission 90% of the time, then out of the ten remaining people, 9 would be infected. Condoms would comprise 50% of the new infections (9 out of 18 despite having a much lower infection rate. These are hypothetical figures but that's why the statistic provided in the study is not intended to enlighten. If you don't say what the transmission rate is, then you are not making a fair comparison.

[broncofan]

I don't even know what that paragraph means. As of now, next to no one is on truvada. This study has nothing to do with it.
That you don't understand her initial point and don't understand her hypothetical either is embarrassing. A logical person looks at a study that says 51% of new transmissions are in people using condoms and says "I bet that means a lot of people are using condoms and having a lot of sex. Also condoms are not infallible as no single method is."

[lifeisfiction]

That you don't understand her initial point and don't understand her hypothetical either is embarrassing. A logical person looks at a study that says 51% of new transmissions are in people using condoms and says "I bet that means a lot of people are using condoms and having a lot of sex. Also condoms are not infallible as no single method is."

Bingo. Bronco gets what Trish and I was getting at.

(I just want to know how much West is getting paid, because I want in.)

[dreamon]

Because they're selling it as HIV prevention and allowing entire states (NY, Michigan, Mass., so far) to recommend it as such. If it actually doesn't prevent HIV.....do the math.

You mean the company selling the drug says it does something? Clearly it must do that. I've never heard of a company using false or misleading marketing.

[broncofan]

You mean the company selling the drug says it does something? Clearly it must do that. I've never heard of a company using false or misleading marketing.
You know what's interesting. There was a court decision not too long ago that said the FDA does not have a right to prevent a drug company from disseminating scientific studies that are technically true but misleading. So if there have been four studies and one of them is positive, the company can distribute the one positive study with their marketing materials and not mention the other three. That's my recollection of the holding anyway.

It was actually a first amendment case...they are on more solid ground policing false statements, although it may take them a while to figure out something is patently false. Also, even with our stringent drug approval process, it may take decades until all of the longer term side effects of a drug are known. I am not an expert on this but I know I've been on at least two previously popular drugs that were pulled from the market for causing fatal arrhythmias.

None of this is to say people shouldn't take Truvada or that the FDA doesn't do the best job they can. But don't expect you can know everything about a drug from reading even all of the literature now available on it.

[Westheangelino]

For all of you that are claiming that Gilead is marketing the drug, publishing biased studies, misleading the public, ETC: They didn't write or fund these studies!!!!


Truvada is NOT a new drug. It was never intended to be used as a preventative measure for HIV infection. It was developed and has been used as part of the cocktail of HIV antiretroviral therapies for over twelve years now.

[trish]

Not only wasn't Truvada ever intended to be used as a preventative measure, it is NOT by itself, over any extended period of time, an effective preventative measure against the spread of HIV. Even if you're on Truvada, PLEASE USE A CONDOM TOO.

[lifeisfiction]

Not only wasn't Truvada ever intended to be used as a preventative measure, it is NOT by itself, over any extended period of time, an effective preventative measure against the spread of HIV. Even if you're on Truvada, PLEASE USE A CONDOM TOO.

Well said. I couldn't say it better myself.

[Westheangelino]

Not only wasn't Truvada ever intended to be used as a preventative measure, it is NOT by itself, over any extended period of time, an effective preventative measure against the spread of HIV. Even if you're on Truvada, PLEASE USE A CONDOM TOO.


THIS IS ABSOLUTE BULLSHIT!!!!!!!!!!!!!!


Truvada is 1. More effective than condoms 2. Condoms are not needed in concurrence with Truvada in order to be effective.


THIS IS A HIGHLY EFFECTIVE MIRACE DRUG!!!!!!!!! GET ON IT

[broncofan]

I think the main point in this thread is that whatever you do, consider it carefully. Do not simply listen to Westheangelino, who will literally say anything to promote condom-less sex.

Whenever a drug has a new use, the risks associated with that use change. A drug that is administered acutely for a month may have different risks than one that is administered once daily for life.So your claim that Truvada has been around for twelve years and everything is known about it doesn't make much sense to me. I'll give you a few examples of drugs whose safety depended on their safe administration, which was only known years after they were initially marketed. Bupropion is perfectly safe at certain doses, but was pulled from the market because it caused seizures at the initial doses it was given at. It was then re-marketed at safe, non-seizure inducing doses. Monoamine oxidase inhibitors are reasonably safe when taken with a restricted diet, but were initially pulled from the market for killing people via serotonin syndrome and hyperpyretic crisis. Seldane I think was on the market for nearly ten years before it was pulled from the market for causing fatal arrhythmias. I'm sure the list goes on and on. But you're certain about the safety of Truvada taken daily for the rest of your life?

Again, I'm not saying it's the wrong choice for everyone. I just doubt all of the risks are known.

[trish]

THIS IS ABSOLUTE BULLSHIT!!!!!!!!!!!!!! No, it’s mathematics using your numbers. Please see post and answer post 290 http://www.hungangels.com/vboard/showpost.php?p=1539155&postcount=290


Truvada is 1. More effective than condomsThis may be true. My argument grants that it is 99% effective (the number you posted).


2. Condoms are not needed in concurrence with Truvada in order to be effective. If you’re happy with only a 74% chance of not getting infected within the next three decades, then yes...you won’t need to use condoms with truvada.


If for any extended period of time you expect to be engaging in behaviors where the effectiveness of truvada in preventing HIV infection is the advertised 99%/yr and you do not plan to supplement that protection then you will be putting your life and your health at serious risk: The probability that you won’t get infected by year N is (0.99) to the Nth power; i.e. (0.99)^N. The probability of getting infected with HIV by year N is (1-(0.99)^N).

On the other hand, assume the effectiveness of condoms is only 90%/yr. If you use condoms with truvada, then the probability getting infected the first year is the equal to the probability that both independent methods of prevention fail, namely (1-.99)(1-.9). So the effectiveness of the combo (condoms and truvada) is (1 - (1-.99)(1-.90)) 100% = 99.9%. The probability of getting infected by year N is therefore (1-(0.999)^N).

Using truvada alone, the probability that you will get infected sometime over the next 30 years is (1-(0.99)^30) = 0.2603.
Using truvada with condoms the probability that you will get infected sometime over the next 30 years is (1 - (0.999)^30) = 0.0296.

Below is a chart that compares the expected number of HIV infections between a group of 100 people who use truvada alone and a group of 100 who use condoms with truvada.

It may be the case that in the future truvada will be proven to be more than 99% effective over one year's use. In that case I'll revise the model. Perhaps I'm interpreting the reported effectiveness incorrectly (we already saw in this thread the difficulty in obtaining precise definitions of the published numbers). If nothing else, I think this comparison illustrates how well even a less effective supplementary preventative measure can amplify the effectiveness of your primary choice of prevention. WHATEVER ELSE YOU USE, USE A CONDOM, PLEASE.

[Westheangelino]

No, it’s mathematics using your numbers. Please see post and answer post 290 http://www.hungangels.com/vboard/showpost.php?p=1539155&postcount=290

This may be true. My argument grants that it is 99% effective (the number you posted).

If you’re happy with only a 74% chance of not getting infected within the next three decades, then yes...you won’t need to use condoms with truvada.


If for any extended period of time you expect to be engaging in behaviors where the effectiveness of truvada in preventing HIV infection is the advertised 99%/yr and you do not plan to supplement that protection then you will be putting your life and your health at serious risk: The probability that you won’t get infected by year N is (0.99) to the Nth power; i.e. (0.99)^N. The probability of getting infected with HIV by year N is (1-(0.99)^N).

On the other hand, assume the effectiveness of condoms is only 90%/yr. If you use condoms with truvada, then the probability getting infected the first year is the equal to the probability that both independent methods of prevention fail, namely (1-.99)(1-.9). So the effectiveness of the combo (condoms and truvada) is (1 - (1-.99)(1-.90)) 100% = 99.9%. The probability of getting infected by year N is therefore (1-(0.999)^N).

Using truvada alone, the probability that you will get infected sometime over the next 30 years is (1-(0.99)^30) = 0.2603.
Using truvada with condoms the probability that you will get infected sometime over the next 30 years is (1 - (0.999)^30) = 0.0296.

Below is a chart that compares the expected number of HIV infections between a group of 100 people who use truvada alone and a group of 100 who use condoms with truvada.

It may be the case that in the future truvada will be proven to be more than 99% effective over one year's use. In that case I'll revise the model. Perhaps I'm interpreting the reported effectiveness incorrectly (we already saw in this thread the difficulty in obtaining precise definitions of the published numbers). If nothing else, I think this comparison illustrates how well even a less effective supplementary preventative measure can amplify the effectiveness of your primary choice of prevention. WHATEVER ELSE YOU USE, USE A CONDOM, PLEASE.

While I appreciate the time you used to draw a graph, it is still doesn't change the fact that you don't understand how medications work or how their efficacy is gauged.

The initial study was over 18 months. When blood levels showed that Truvada was being taken at least five times a week NOT ONE PERSON BECAME POSITIVE. Guess who did? THE PEOPLE WHO DIDNT TAKE THE PILL!!!!

[Tapatio]

Wes, of all the people who regularly post here Trish is probably least likely to not understand something.

[trish]

...you don't understand how medications work or how their efficacy is gauged. Perhaps I don't understand. Still I think the analysis I gave illustrates how well even a less effective supplementary preventative measure can amplify the effectiveness of your primary choice of prevention. Surely you don't believe that two people who expose themselves for different lengths of time take equal risks provided they're on truvada, do you? You're the one who said the effectiveness of truvada was 99%. Starting with your number and the assumption that you're only going to use travada with no other preventative measures, teach me how YOU calculate the probability of getting infected by year N.

[lifeisfiction]

Your body will build a resistance to any medication taken over a certain duration Furthermore the problem I find with Truvada is the initial statistical number of 99% effectives was a estimation of test participants taking the medication semi-properly over the designated period of time. Trish is right with the decrease of effectiveness. Comdons bare no substantial weakness over a period of time, because it is not a chemical agent, but a physical barrier.

Furthermore, the study was improperly concluded. The medication was not monitored under the ideal situation at should have been. The sample size of those who properly took the medication was almost non-existent. Instead they assume it would be more effective if a person had a large dose. The problem is the drug has traditional been given with other medication. It was never given solely as a treatment for HIV. So here you have a drug that researchers have not determine the effectiveness of the drug by itself. Simply put in a medical study you want to see the medication act under the ideal situation.

So you can believe its 99% effective, but in reality it will far less effective. It was poor study hence I would recommend proceeding with caution. For what I have glean from the many forums about people taking Truvada, they are treating it as an alternative for condoms. That in of itself maybe troublesome since the Truvada is not as effective. Truvada and condoms will provide excellent protection.

I am waiting to see those who are using Truvada exercise caution and care in choosing sexual situations that presents low risk. I think that in of itself will be a big determining factor for the perception and care of those who use Truvada. My fear is people really think this alone is all you need.

[Westheangelino]

^ And what of the studies with serodiscordant couples? Not one on Truvada came up positive.

Truvada IS a replacement for condoms and will stop the HIV epidemic IF ONLY MORE PEOPLE KNEW ABOUT IT.

Also, you say the sample size was nearly nonexistent? How many does it take to be existent?

[RobynBlakeTS]

Truvada IS a replacement for condoms and will stop the HIV epidemic IF ONLY MORE PEOPLE KNEW ABOUT IT.

No its not, with that thinking you'll replace an HIV epidemic with a herpes, warts, gonorrhoea, hepatitis epidemic.

Truvada does sound and could be a wonder drug but only in conjunction with condoms, not as a replacement to condoms.

[Westheangelino]

^ Condoms are not effective against herpes, warts, or hepatitis. Just so you know

[RobynBlakeTS]

^ Condoms are not effective against herpes, warts, or hepatitis. Just so you know

In your opinion they are not.

In mine they are, they wont 100% help but they do improve your odds so that is a good thing. Not using a condom only increases your odds of catching something so be sensible and use one in conjunction with truvada then your pretty much protected from HIV and from other STI's. Using truvada just on its own and wow you got a degree of protection from HIV but no assistance for protection from other STI's

[Westheangelino]

http://www.sfgate.com/health/article/Condoms-not-effective-against-HPV-or-herpes-3650285.php


It's not my opinion. None of these statements are opinions.

[Westheangelino]

“We know that uptake of PrEP among men who have sex with men (MSM) has been limited, partly due to misinformation in the community about its safety and effectiveness."

http://www.metroweekly.com/2014/10/hrc-endorses-truvada-for-prep/

And the Human Rights Campaign, the largest LGBT org in the country, just endorsed Truvada. BOOM GOES THE DYNAMITE!!!!

[dreamon]

For all of you that are claiming that Gilead is marketing the drug, publishing biased studies, misleading the public, ETC: They didn't write or fund these studies!!!!


Truvada is NOT a new drug. It was never intended to be used as a preventative measure for HIV infection. It was developed and has been used as part of the cocktail of HIV antiretroviral therapies for over twelve years now.

If they aren't marketing their drug, they're doing it completely wrong. As a for-profit organization, and one that is publicly traded at that, they have a responsibility to their shareholders to turn a profit. If they aren't actively marketing their products to increase sales, they're doing their shareholders an active disservice.

[trish]

Wes, this is your claim that the effectiveness of truvada is 99% ->
http://www.hungangels.com/vboard/showpost.php?p=1538915&postcount=262

These are simple calculations comparing the expected performance of truvada alone and truvada with condoms over various periods of time.->

http://www.hungangels.com/vboard/showpost.php?p=1539155&postcount=290

http://www.hungangels.com/vboard/showpost.php?p=1540807&postcount=301

These calculations use ordinary elementary probability theory treating each year of use as an independent experiment. If this approach is in error please explain exactly why and provide your own calculation so that your readers understand precisely how to interpret and use your notion of 99% effective. In particular how do YOU calculate the probability of infection by year 10? Year 20? Year 30? Etc.->

http://www.hungangels.com/vboard/showpost.php?p=1540926&postcount=304

[MrBest]

trish dont bother anymore, he hates condoms and doesnt want to be stigmatized about his status

[lifeisfiction]

We are going to know if 5 years the effectiveness of the drug. I fear this will lead to higher risk sexual activities with higher transmissions, because many people are under the assumption this drug will end HIV transmission if everyone is on it. It happens more than people know the selling of drugs that do not perform as prescribed. I would recommend caution, but I guess to some people my words are like grabbing after the wind, completely useless. Be safe folks.

[MrBest]

people are already under the impression that ARVs are multivitamins

[TSMichelleAustin]

This thread is still going on? U guys it doesnt matter what u say to him, he doesnt care to hear or listen.

Condoms do work, I was in a relationship with HIV+ person for 3 years and we had lots of sex just with condoms. If theory goes to what he is claiming condoms dont work, I would be positive as well. So, I rather have a rubber than some pill to keep my life healthy.

[Westheangelino]

trish dont bother anymore, he hates condoms and doesnt want to be stigmatized about his status

I'd love to know what you know about me.....last time I checked (quite recently) I was negative. Are you saying I'm POZ? If so, please directly say so.


Michelle, I applaud your exemplary past use of condoms. You happen to be an outlier. I never said condoms were not effective when used properly. They are. The problem is that people won't or can't use them for various reasons, and Truvada is the answer.

[trish]

I'd love to know what you know about me.....I know you think that you're a "Fit, smart, bottom guy who knows what I want," and that you're "Looking for an awesome tgirl to hang with and go from there." Good luck with that. I hope she uses condoms.

[lifeisfiction]

I'd love to know what you know about me.....last time I checked (quite recently) I was negative. Are you saying I'm POZ? If so, please directly say so.


Michelle, I applaud your exemplary past use of condoms. You happen to be an outlier. I never said condoms were not effective when used properly. They are. The problem is that people won't or can't use them for various reasons, and Truvada is the answer.

She never implied you were poz. She only said that it has been a proven form of protection. You have been arguing condoms are not effective, hence the need for her statement. Now I am curious to hear the won't or can't reasons.

[TSMichelleAustin]

I never said u were POZ! Read the fucking thing I said. I said, u dont listen or care to. I just stated that ur claim that condoms dont work is wrong!!! Its stupid to say condoms dont work, I know many Neg/Poz couples who have a healthy sex life with condoms and the one is still negative. I was just proving a point that you keep bringing up in here, that condoms are not effective and your wrong! Thats all! I never said u were poz, I could care less if you were or not, its none of my business because we are never fucking! And if we ever did it be condoms cuz I wouldnt trust all your barebacking ways!

[fred41]

She never implied you were poz.....


I never said u were POZ! ..........

For the sake of accuracy...he was responding to this post - from MrBest

trish dont bother anymore, he hates condoms and doesnt want to be stigmatized about his status

...which was clearly stated in his reply quote...read it again. I like a heated debate...but I like things to remain accurate also.

[lifeisfiction]

For the sake of accuracy...he was responding to this post - from MrBest


...which was clearly stated in his reply quote...read it again. I like a heated debate...but I like things to remain accurate also.

Well I apologize for the assumption, I thought through my initial reading he was quoting Michelle.

[MrBest]

I'd love to know what you know about me.....
i know this isnt the only thread where you made anticondom posts

[BBaggins06]

Westangelino is no different than all the right wing climate change deniers ...

[Westheangelino]

http://www.theguardian.com/commentisfree/2014/sep/29/new-hiv-drug-truvada-gay-men-us-nhs

A good British take on the issue

[Prospero]

It is obvious that he enjoys sex without a condom and that he has been lucky so far.

But as others have said condoms do work 99.9 per cent of the time. I would still advise their use - even if you accompany that by taking Truvada.

Now he has found a way which suggest he has increased his safety in pursuing his preferred form of sex. IFine and dandy. But isn't going guarantee he will remain disease free - and there are other nasties lurking out there like Hep for instance.

Play safe folks - even if you add Truvada to your gameplan.

[RobynBlakeTS]

http://www.theguardian.com/commentisfree/2014/sep/29/new-hiv-drug-truvada-gay-men-us-nhs

A good British take on the issue

Good article but it just repeats what we've all been saying to you on here, the fear that truvada will replace condoms altogether and lead to a explosion of STD's amongst the community.

[Westheangelino]

"But as others have said condoms do work 99.9 per cent of the time. I would still advise their use - even if you accompany that by taking Truvada."


NO. THEY DON'T. Where on Earth did you get this stat?

[Prospero]

so since condoms are not 100 per cent guaranteed you inveigh against their use westheangelino? That is a pretty dumb response.

[trish]

The effectiveness of truvada is estimated by the CDC to be 92% over one year of high risk exposure (NOT the 99% that Wes advertises).

http://www.cdc.gov/hiv/prevention/research/prep/

The chart below uses Wes's 99% effectiveness of truvada and also assumes only a 90% effectiveness for condoms. In this way it's biased for Wes's POV and yet it shows considerable regret for those who do not supplement their truvada use with condoms. The model uses elementary probability theory and treats each year's use as a independent experiment. Wes claims the model wrong but doesn't offer any detailed criticism other than "medications don't work like that". Tell us Wes, how do they work? How do YOU calculate the expected number of HIV transmissions using truvada alone over a ten year period...a twenty year period...etc.? How do YOU calculate the regret of not supplementing truvada use with condoms?

[Teydyn]

How do YOU calculate the expected number of HIV transmissions using truvada alone over a ten year period...a twenty year period...etc.? How do YOU calculate the regret of not supplementing truvada use with condoms?
He doesnt.

Because Truvada is so awesome, you dont need math, condoms or common sense...

[Westheangelino]

trish dont bother anymore, he hates condoms and doesnt want to be stigmatized about his status


He doesnt.

Because Truvada is so awesome, you dont need math, condoms or common sense...


Use condoms if you want to. If this is a strategy that works for you and your partner(s) then go for it. I am not saying that condoms are not effective (when used perfectly). On an individual basis, they are. As a strategy to END not just stem the tide of an epidemic, they are NOT EFFECTIVE AS A STRATEGY. We have 50K new HIV infections in the US every single year.

Truvada's effectiveness (just like condoms) is measured on how well it's used. Trish, you can make any graph you want, but it doesn't illustrate anything. Even you have to admit these two things: the CDC numbers take into account whether or not someone is using the drug as directed or not and in published studies about serodiscordant couples, not ONE negative partner became positive when taking Truvada as directed.

[Westheangelino]

And if you're not going to believe me (and, really, why should you? I'm just some wanker on a message board), perhaps you'll take stock in the opinions of the ACLU, the CDC, the WHO, the Governor of NY, and a myriad of AIDS activists and health professionals.


http://www.advocate.com/31-days-prep/2014/10/24/35-activists-doctors-and-organizations-speak-out-support-prep

[dreamon]

Use condoms if you want to. If this is a strategy that works for you and your partner(s) then go for it. I am not saying that condoms are not effective (when used perfectly). On an individual basis, they are. As a strategy to END not just stem the tide of an epidemic, they are NOT EFFECTIVE AS A STRATEGY. We have 50K new HIV infections in the US every single year.

How many of those 50,000 infections are due to condom failure?

[Tapatio]

Hey, side question- say you fulfilled Wes' fantasy and were taking the pill daily-


Would you have sex with someone you knew to be HIV positive?

I totally wouldn't.

No.

Fucking.

Way.

[guyinpr]

Truvada + Condoms seems to be the smart bet.

[kaientai]

All the links wes and other people posted effectivenes vary's from 70 to 99%. Plus there are side effects for Truvada. And it is not the holy grail against H.I.V on a bad day you can still catch or give it. It comes down to the Swiss effect if you are in a commited relationship taking the medicine daily with food on a scheduled time, yes you can have bare sexs if you are not coming down with something . I am not saying condoms are 100% but to me they seem like a safer bet

[Prospero]

How many of those 50,000 infections are due to condom failure?

Or people who simply don't use condoms now that there is a widespread belief that HIV is a manageable chronic rather than fatal condition with the use of anti-retroviral drugs.

[Westheangelino]

Or people who simply don't use condoms now that there is a widespread belief that HIV is a manageable chronic rather than fatal condition with the use of anti-retroviral drugs.


HIV IS a manageable disease with proper treatment.


I have no idea how many of the 50K infections are due to condom failure. I would bet not many. I'm not saying condoms are not effective. I'm saying condoms have not been an effective strategy for ending the HIV epidemic.


As for the question about fucking a POZ person, I absolutely would, provided they were on treatment. Undetectable POZ patients do NOT pass on HIV. They are not infectious.

[Prospero]

That last remark by westheangelino is irresponsible bollocks. Undetectable does NOT mean not infectious. Ask a doctor. It might make the risk lower but definitly does not mean they are not a risk.

As for HIV being manageable. yes. True. But they also say that in later life the chances of dying earlier from other infections is heightened. Plus HIV also has the ability to mutate. So drug treatments presently effective at controlling it may well not continue to work. Plus who wants to have to religiously take a tough regime of drugs - some of which have side effects - for the rest of their life for the pleasure of a few minutes of bareback sex.

Play safe. Use condoms and Truvada. Do NOT forsake the great degree of safety that the use of condoms provides.

[Sexyjoe84]

Hi,

I'm taking truvada and kaletra after a possible exposure during oral...
The side effects aren't nice.. Not even sure I should be taking them to be fair but still, better safe than sorry...

Great thread though with good discussions.

[trish]

Trish, you can make any graph you want, but it doesn't illustrate anything.Yes, if I just drew any old graph I felt like drawing. But the chart I posted is constructed from the simple, well known algorithm for computing the expected number of failures in N independent runs of a random procedure with known probability of success. I explained the procedure here
http://www.hungangels.com/vboard/sho...&postcount=290 (http://www.hungangels.com/vboard/showpost.php?p=1539155&postcount=290)
and here
http://www.hungangels.com/vboard/sho...&postcount=301 (http://www.hungangels.com/vboard/showpost.php?p=1540807&postcount=301)

The chart illustrates over time the expected number of HIV transmissions for a group of one hundred people using truvada alone and compares that to the expected number of transmissions for a group of one hundred people using condoms along with truvada. Even if the effectiveness estimates are in error the chart demonstrates how well the supplementary use of condoms can reduce the risk of HIV transmission. The model assumes the group behaviors are such that 99% is the appropriate measure of truvada's effectiveness over a one year period and that 90% is the appropriate measure of the effectiveness of condom use over a one year period.

Each curve on the chart is labeled with the mathematical form of the model used to construct the curve so that anyone can independently derive the model and verify that the equation is correct.

Wes, after making the claim that the chart illustrates nothing, I expected you explain why that's the case. Instead you immediately follow your claim with...


Even you have to admit these two things: the CDC numbers take into account whether or not someone is using the drug as directed or not and in published studies about serodiscordant couples, not ONE negative partner became positive when taking Truvada as directed.Wes, I'm not using the CDC numbers. I'm using YOUR numbers. The number you pulled out of your ass was 99%.
http://www.hungangels.com/vboard/sho...&postcount=262 (http://www.hungangels.com/vboard/showpost.php?p=1538915&postcount=262)
Would you like now to revise that estimate? To what value and why?

You have yet to state clearly, or in any other fashion, why truvada use over time cannot be modeled as a run of independent random experiments. Perhaps don't properly understand what YOU mean by "99% effective." Perhaps YOU could calculate for us the odds of HIV transmission over time using truvada alone and then using truvada with condoms. It is exactly the kind of information someone contemplating its long term use would want to have.

[Westheangelino]

That last remark by westheangelino is irresponsible bollocks. Undetectable does NOT mean not infectious. Ask a doctor. It might make the risk lower but definitly does not mean they are not a risk.

As for HIV being manageable. yes. True. But they also say that in later life the chances of dying earlier from other infections is heightened. Plus HIV also has the ability to mutate. So drug treatments presently effective at controlling it may well not continue to work. Plus who wants to have to religiously take a tough regime of drugs - some of which have side effects - for the rest of their life for the pleasure of a few minutes of bareback sex.

Play safe. Use condoms and Truvada. Do NOT forsake the great degree of safety that the use of condoms provides.


Complete bollocks? This two year study, which I'm sure you've never read, would say YOU are the one spouting nonsense.

http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748/

[Westheangelino]

Hi,

I'm taking truvada and kaletra after a possible exposure during oral...
The side effects aren't nice.. Not even sure I should be taking them to be fair but still, better safe than sorry...

Great thread though with good discussions.


1. HIV is not transmitted through oral sex. Why do you think you could have been infected?

2. You're taking PEP (post exposure) as opposed to PrEP (pre-exposure). Of course you're having some side effects. You're taking two drugs not one and in much higher dosages than what would be given as PrEP. Please educate yourself before you start warning of side effects regarding Truvada for PrEP. From all accounts I've heard of people actually on it for prevention, the side effects range from mild to nonexistent. I can't wait til I am on it myself to let you guys know how it's going.

[Tapatio]

1. HIV is not transmitted through oral sex.


Congratulations. You're spreading more misinformation.

This thread isn't just annoying and logic-impaired; it's also dangerous. You should be proud.

Low risk does not mean no risk.

http://www.cdc.gov/hiv/risk/behavior/oralsex.html

[Westheangelino]

If I may retort:

http://www.aidsmap.com/Oral-sex-risk-very-low-but-not-zero-concludes-systematic-review/page/1432786/

[Prospero]

And according to British NHS information sites having such a low viral count that it is undetectable lowers but does not eliminate the risk of infection. So stop preaching dangerous misinformation. If anyone is infected because they follow your advice then you should be ashamed and - were it at all possible - be held criminally culpable.

[Westheangelino]

^ Would you say the same of anyone preaching a condom only approach that tells people not to take Truvada? What of campaigns that say Truvada isn't effective? I doubt you would give them the same scrutiny.

[lifeisfiction]

Congratulations. You're spreading more misinformation.

This thread isn't just annoying and logic-impaired; it's also dangerous. You should be proud.

Low risk does not mean no risk.

http://www.cdc.gov/hiv/risk/behavior/oralsex.html


Actually, he is sort of right. There are doctors ( I do like to read medical stuff don't ask), who would sort of agree. Doctors will not say the possibility is zero, meaning since there is exchange of fluid, they can never rule it out as zero. Salvia inhibits in the transmission of the disease. One doctor in years of practice HIV, has not seen the transfer of HIV by oral sex. Those that claim to have acquired that method, when question have change their story about how they received the disease. For the disease to be transferred you need an open wound or sores. Even still you would need some other factors to cause transfer. I have given and receive oral sex and unless the person has sores or cut, then the possibility is pretty much null. The more diligent you are in having sex, the more safe you will be.

Many times people are not aware of the risks they take while engaging sex. I have been looking at Truvada and its history since West keeps going on and on about it more clearly. It has been given as prep for a few years. I find that some people on Truvada have an ambivalence to condom use as I suspected and would prefer the risk of engaging in unprotected sex. Those are the people who Truvada is really targeted. They can continue to have sex with lowering the chance of transmission. Now, by how much I am very curious. That's what I have been keeping my eye out for. I have read some interesting things about it, but then again HIV is not as easily transmitted as people tend to think.

Condoms are great for safe sex, but this product is aimed at people who would care less for condoms. Before we throw stones at this group, more people have engaged in bareback sex then they would like to admit whether in a relationship or in the heat of the moment. I've been offered bareback sex too many times from people I have known for one night, which always scares me. So I think we should be more understanding of their decisions. It still does not excuse their irresponsible behavior, but at least we can understand their decision.

I will certainly keep an eye on this topic. I'm very curious to how its going to progress. I believe there are going to be some major lawsuits against the pharmaceutical company in the future, this is my opinion.

[Westheangelino]

Actually, he is sort of right. There are doctors ( I do like to read medical stuff don't ask), who would sort of agree. Doctors will not say the possibility is zero, meaning since there is exchange of fluid, they can never rule it out as zero. Salvia inhibits in the transmission of the disease. One doctor in years of practice HIV, has not seen the transfer of HIV by oral sex. Those that claim to have acquired that method, when question have change their story about how they received the disease. For the disease to be transferred you need an open wound or sores. Even still you would need some other factors to cause transfer. I have given and receive oral sex and unless the person has sores or cut, then the possibility is pretty much null. The more diligent you are in having sex, the more safe you will be.

Many times people are not aware of the risks they take while engaging sex. I have been looking at Truvada and its history since West keeps going on and on about it more clearly. It has been given as prep for a few years. I find that some people on Truvada have an ambivalence to condom use as I suspected and would prefer the risk of engaging in unprotected sex. Those are the people who Truvada is really targeted. They can continue to have sex with lowering the chance of transmission. Now, by how much I am very curious. That's what I have been keeping my eye out for. I have read some interesting things about it, but then again HIV is not as easily transmitted as people tend to think.

Condoms are great for safe sex, but this product is aimed at people who would care less for condoms. Before we throw stones at this group, more people have engaged in bareback sex then they would like to admit whether in a relationship or in the heat of the moment. I've been offered bareback sex too many times from people I have known for one night, which always scares me. So I think we should be more understanding of their decisions. It still does not excuse their irresponsible behavior, but at least we can understand their decision.

I will certainly keep an eye on this topic. I'm very curious to how its going to progress. I believe there are going to be some major lawsuits against the pharmaceutical company in the future, this is my opinion.

Aside from your last sentence, this is maybe the most sensible thing posted in reply to my posts. Thank you, sincerely.

[Tapatio]

Actually, he is sort of right. There are doctors ( I do like to read medical stuff don't ask), who would sort of agree. Doctors will not say the possibility is zero, meaning since there is exchange of fluid, they can never rule it out as zero. Salvia inhibits in the transmission of the disease. One doctor in years of practice HIV, has not seen the transfer of HIV by oral sex. Those that claim to have acquired that method, when question have change their story about how they received the disease. For the disease to be transferred you need an open wound or sores. Even still you would need some other factors to cause transfer. I have given and receive oral sex and unless the person has sores or cut, then the possibility is pretty much null. The more diligent you are in having sex, the more safe you will be.

Many times people are not aware of the risks they take while engaging sex. I have been looking at Truvada and its history since West keeps going on and on about it more clearly. It has been given as prep for a few years. I find that some people on Truvada have an ambivalence to condom use as I suspected and would prefer the risk of engaging in unprotected sex. Those are the people who Truvada is really targeted. They can continue to have sex with lowering the chance of transmission. Now, by how much I am very curious. That's what I have been keeping my eye out for. I have read some interesting things about it, but then again HIV is not as easily transmitted as people tend to think.

Condoms are great for safe sex, but this product is aimed at people who would care less for condoms. Before we throw stones at this group, more people have engaged in bareback sex then they would like to admit whether in a relationship or in the heat of the moment. I've been offered bareback sex too many times from people I have known for one night, which always scares me. So I think we should be more understanding of their decisions. It still does not excuse their irresponsible behavior, but at least we can understand their decision.

I will certainly keep an eye on this topic. I'm very curious to how its going to progress. I believe there are going to be some major lawsuits against the pharmaceutical company in the future, this is my opinion.

I get where you're coming from but it doesn't seem right at all.

He stated that one can not get HIV through oral sex. That's not correct. Not even "sort of."

This conversation is a mitigation of fact in support of the mitigation of risk.

[Westheangelino]

http://www.newscientist.com/article/dn1156-risk-of-hiv-from-oral-sex-may-be-zero.html#.VFAslWSwKNA

[lifeisfiction]

I will reiterate some of my points in a shorter simpler fashion.

1. In terms of oral transmission of HIV there is medical possibility, looking at how the disease is transmitted versus what they have found in people who have acquired HIV. Some medical professionals, those who work HIV and STD transmission meaning the 10,000s of patients a year typical find it rarely or never see HIV transmitted through oral sex alone. If they do, there is additional factors not commonly found during the act of oral sex.

Furthermore those who have claimed to have acquired HIV through oral sex tend to change their stories upon further investigation lower the credibility of their claim. (People tend to be embarrassed about their riskier sexual activities.) So while it seems medically possible, the actual number of people who acquired it by oral sex does not match the actual medical probability.

2. There are a group of people who will not use condoms. This group pose the highest risk of transmitting HIV. Many in medical field hope that since they will not use the condom method, that Truvada will provide some sort of protection for that group who would not use condoms consistently during their sexual activities. I believe West would fall into this group.

Furthermore I said many people at one time or another have had bareback sex. So many can understand their desire of it. I wanted not to have condemning tone to this high risk group. Of course I think they are being irresponsible, but they would care less of my opinion.

[Tapatio]

If I may retort:

http://www.aidsmap.com/Oral-sex-risk-very-low-but-not-zero-concludes-systematic-review/page/1432786/


If by "retort" you mean "agree" then you did very well.

Wes, words mean things. Important things.



.

[Tapatio]

Full disclosure: I've never given head through a condom. I don't intend the next penis in my mouth to be covered, or the next, or the next.

I definitely agree that the risk is low, or I wouldn't take it.

I also have impeccable oral hygiene, though. Floss, people, every day.

[dreamon]

I have no idea how many of the 50K infections are due to condom failure. I would bet not many. I'm not saying condoms are not effective. I'm saying condoms have not been an effective strategy for ending the HIV epidemic.

You just said that condom failure has not resulted in many infections.

So if condom failure does not result in many infections, what is causing all these infections?

Could it be... that people aren't wearing condoms?

[fred41]

Full disclosure: I've never given head through a condom. I don't intend the next penis in my mouth to be covered, or the next, or the next.

I definitely agree that the risk is low, or I wouldn't take it.

I also have impeccable oral hygiene, though. Floss, people, every day.

I agree,...pretty much same here...
though to be safe...I believe it's been said not to floss right before giving head.

[Westheangelino]

You just said that condom failure has not resulted in many infections.

So if condom failure does not result in many infections, what is causing all these infections?

Could it be... that people aren't wearing condoms?


DUH. That's why I said they are not effective as a strategy to END an epidemic. If you want HIV to remain at current levels, please continue. But there will always be a portion of the population that will not or cannot wear condoms. So, clearly something else is needed. That something else has arrived, and it's called Truvada.

As for oral sex,

ANYTHING is possible. The chances of me winning the lottery are not zero, but I'm not rushing to go buy a ticket. The chances of me being killed by a stray boulder in Runyon canyon are not zero, but it wouldn't keep me from hiking there. The chances of getting HIV by sucking a dick are not zero,but.....you get the picture right?

[fred41]

Wes, are you on it yet?

[Sexyjoe84]

Hi West,

I had never heard of PEP before but when I went to my local GUM clinic the nurse mentioned it and explained what it was and I pushed to have it. As the whether the chances of catching HIV are low in terms of oral, I'm still totally unsure and as you say, uneducated in that respect so please feel free to educate me. It will certainly help.
This was all after my first ever experience with a TS lady and I was kind of worried afterwards...

After this experience I don't think I'll do it again but I'm glad that PEP has been an option.

[Jericho]

As the whether the chances of catching HIV are low in terms of oral, I'm still totally unsure and as you say, uneducated in that respect so please feel free to educate me. It will certainly help.


Or, instead of waiting around for someone else to do it, you could educate yourself on the risks involved.
Just sayin' :shrug

[Westheangelino]

Or, instead of waiting around for someone else to do it, you could educate yourself on the risks involved.
Just sayin' :shrug



Yeah, I second that. GOOGLE

[Sexyjoe84]

Obviously I've googled. Infact, Google has been more of a hindrance than anything, too many contradictions and what not. I thought possibly, first hand experience from your good selves would be more appropriate??

[Tapatio]

I agree,...pretty much same here...
though to be safe...I believe it's been said not to floss right before giving head.

Agreed. It's just not sexy.


(Plus you could cause bleeding, but really- not sexy.)

[trish]

The NewScientist report ( http://www.newscientist.com/article/dn1156-risk-of-hiv-from-oral-sex-may-be-zero.html#.VFBMGedAKHl ) says,

“The chances of contracting HIV through unprotected oral sex MAY be zero...” (capitalization mine)

It also says,

“However, several cases have been reported which SUGGEST that oral sex can result in HIV transmission, so the latest findings must be interpreted cautiously, experts say.” (capitalization mine)

The study is being carried out by Kimberly Page Shafer of the Univ. of Calif. at San Francisco. The article reports the study is ongoing but fails to mention how long it’s been in progress (making it difficult to attach any real significance to the other reported statistics). The article maintains

“Shafer herself says that since the results are based on a relatively small sample, they should be treated with caution. However, she believes that some reports have "overinterpreted the probability of infection".

Various other sexually transmitted diseases, such as gonorrhoea, chlamydia and syphilis, are transmitted orally, so people might still want to refrain from unprotected oral sex.”

The article reports that 198 people (mostly male) are participating in the study. They have had no anal or vaginal sex. On average these participants have two partners with whom they have oral sex. 98% of these have had unprotected oral sex (though the article fails to mention how regularly and over what periods of time) and 20% of these were with an HIV-positive partner.

So two partners for each of 198 people is about 396 partners. Ninety eight percent of those is about 388. Twenty percent of those is 78 unprotected ‘partnerings’ with HIV-positive partners over an unstated period of time with unstated regularity. Out of those 78 ‘partnerings’ there have been no detected transmissions of the HIV virus. Had there been they would have PRESUMABLY been oral transmissions.

Personally, I would use protection when giving oral to new acquaintances. After I get to know somebody for a time, asked them a few questions, observed their behaviors...if I come to really trust them I may relax my guard. Bear in mind that HIV isn’t your only worry. Gonorrhoea isn’t trivial though it’s usually curable. Herpes isn’t deadly but it’s an unsightly pain in the ass (or elsewhere) and never goes away (except intermittently). [Actually, since I been in a stable relationship for several years I no longer have sex -protected or otherwise- with mere acquaintances. But I know that when you're single it's different.]

[MrBest]

trish what are the risks bottoming without protection

[StlyeMeCunty]

I actually am on Truvada, and I love the extra layer of protection it provides. I still have sex with condoms as well.

:D

[trish]

MrBest. Your question got me thinking about this in a different way. I may have to revise my opinion of Truvada. Gotta sleep on it and think it through in the morning before I reply.

[Westheangelino]

trish what are the risks bottoming without protection

Perhaps the riskiest thing you can do.

[Westheangelino]

HUGE NEWS. Not often a study stops giving placebos mid study.

http://www.aidsmap.com/page/2917367/

[trish]

trish what are the risks bottoming without protection
First let me say that I'm not the person to ask. I have absolutely no training in any field related medicine or epidemiology. Like everyone else I read, I Google, I listen and I think.

This is a pertinent question. According to the CDC bottoming is the second riskiest behavior in regards to the transmission of HIV. (The riskiest activity is blood transfusion with from HIV infected person). Using the CDC numbers, the risk of receptive anal sex (apparently scientific etiquette for bottoming) is 12 to 13 times the risk of insertive anal sex. http://www.cdc.gov/hiv/policies/law/risk.html

The risk of HIV transmission for the unprotected bottom (according to the above CDC link) is 138 transmissions out of 10 000 exposures.

Now I’m going to engage in some risky behavior. I’m going to try to compute the probability of transmission given a single unprotected act of receptive anal with an infected partner. Here is the reasoning: Let p denote the probability we seek. Then the probability that single incident doesn’t result in transmission is (1-p). So the probability that there will be no transmission if there are two such incidents is (1-p)(1-p). The probability that there will be no transmission over a run of three such encounters is (1-p)(1-p)(1-p), and so on. So the probability of no transmissions during a run of N such encounters is (1-p)^N. So the probability that the bottom is infected sometime during a run of N such encounters is 1-(1-p)^N. Now according to the CDC numbers (if I interpret them correctly), the probability of infection sometime during a run of 10 000 exposures is 138/10000. So 1-(1-p)^(10000) = 138/10000 = 0.0138. This is an equation which can be solved for p. Solving one finds p = 1-(1-0.0138)^(1/10000) = .0000013896.

You can now personalize the model to your situation. For example: Suppose you have unprotected receptive anal sex with an infected partner once or twice a day every day, say on average 550 times a year; i.e. 550 exposures each year. Remember p = 0.0000013896. So the probability that you get infected before the year is out is 1-(1-p)^500 = 0.00069. The probability of transmission before the decade is out is 1-(1-p)^(10*500) = 0.0069. The probability of transmission during the next N years is 1-(1-p)^(N*500). The probability of getting infected over thirty years is 0.02. So there’s a 98% chance of no HIV infection over a thirty year period. That may sound like a risk you’re willing to take, but just keep in mind that 2 out of every hundred of you (all participating in 500 unprotected receptive encounters per year for thirty years) will acquire HIV (not to mention hepatitis, gonorrhea and other STDs).

If this is correct (and please -anyone- inform me of any errors you detect in the reasoning) I am forced to change the way I’ve been modeling Travada use. More on that in a later post.

I think the moral here that one should not bottom without protection (unless -perhaps- you’re monogamous, your partner is trustworthy and both of you are free of STDs).

[trish]

I entered this conversation back on page 21 in an attempt to answer the question, What is the probability of avoiding an HIV infection over a given period of time, if you’re having sex with an infected partner and using a given preventative strategy. I was looking for the probability escaping HIV infection per exposure which could then be easily employed to answer such a question. Wes, Broncofan and myself quickly decided that the numbers the lay-literature calls “effectiveness” was not that probability. So what was it? No one knew. The lay-literature was not helpful, though I should’ve been more persistent in my search. I interpreted “99% effective” in my posts prior to #372 to be the probability of avoiding infection over a year of exposure. Wes objected to my charts and conclusions but he could never put his finger on the source my error. He kept saying “Truvada is 99% effective” but he couldn’t tell me what that meant.

In answering MrBest’s most recent post I ran across these two links:

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

http://www.cdc.gov/hiv/basics/prep.html

Both are CDC webpages. The first provides a table of clearly defined risks for an assortment of sexual activities. For example: The risk of unprotected receptive anal intercourse with an infected partner is ranked at 138 per 10 000 exposures. I explained in my last post (#372) how this determines the probability of a given person acquiring HIV through one unprotected anal receptive exposure to be equal to 0.0000013896.

The second link explains, “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.”

I found these two pieces of information together to be quite enlightening. 92% of the 138 is about 127. The number that is 92% lower than 138 is therefore 138-127 = 11. So when using a PrEP (like Truvada) the risk of transmission through receptive anal sex is 11 out of 10000 exposures. (Notice this is approximately the risk of unprotected oral transmission according to the CDC).

We can now repeat the reasoning in post #372 to find the probability, when using a PrEP, of transmission through one anal receptive exposure. Call this probability p. It’s equal to p = 1-(1-11/10000)^(1/10000) = 0.00000011.

Given this value of p we can compute the probability of transmission during a run of N exposures as 1-(1-p)^N.

For example. Suppose you have anal receptive sex with your HIV infected partner on average of 550 times a year (one to two times a day). Then the probability of transmission within the next thirty years is 1-(1-p)^(30*550) = 0.0018. If there are 100 people exactly like you, then all are expected to be HIV free at the end of the three decade run. This is a much happier prediction than that derived from my prior understanding.

[trish]

Errata for Post #372
The 550 suffered a typo and mutated to 500 in post#372. The probability of transmission before the end of the next 30 thirty is still approximately 0.02 (the mutation error got taken up in the rounding off to the second decimal place).

[Westheangelino]

^ Trish, you're still only half right, but I'm glad you seem to be seeing the light.

Your conclusions are correct, but your reasoning is flawed. Your mixing risk of exposure with no medication with risk while on medication. That's like grouping together people who are vaccinated against polio and those who aren't.

[trish]

Not sure where you think I'm mixing the two. The CDC's 92% means that when using a PrEP the risk is 92% lower than the risk would be without using any protection. Hence one has to take 92% of the risk without protection and complement it to find the risk with PrEP. (This is explained in the second link under the section How Well Does PrEP Work?) Perhaps this is where you think I'm mixing the two erroneously, though at the moment it looks right to me.

[trish]

Errata for Post #373
In post 373 I made the parenthetical remark, "Notice this is approximately the risk of unprotected oral transmission according to the CDC."

However of risk of 11 transmissions per 10000 exposures is equivalent to the risk of unprotected insertive anal. So the correct statement would be: the use of PrEP can reduce the risk of transmission during receptive anal to the risk equivalent to that of unprotected insertive anal.

I misremembered the table and didn't double check before posting. Sorry.

[Westheangelino]

https://www.youtube.com/watch?v=u1WsKvPPZjQ


Can't wait til this is common practice

[trish]

I give up. The reported numbers in this field are all over the place. Consider these two links

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

http://www.aidsmap.com/Estimated-risk-per-exposure/page/1324038/

The first is a CDC webpage for the dissemination of information to the lay public. The second is a NAM page.

According to the CDC
"The estimated per act probability of acquiring HIV from an infected source by...receptive anal intercourse is...138 risks out of 10000 exposures"

According to NAM
The HIV transmission risk per exposure by...receptive anal sex amongst gay men, partner HIV positive is...82%.


What am I missing here? Why are these numbers no commensurate? Are they not both measuring the same thing, namely the risk of HIV transmission per exposure via unprotected receptive anal intercourse with an infected partner? According to the CDC the risk is 138 chances of transmission out of 10000 exposures. Even a naive division demonstrates that's way under 2%. According to NAM that same risk is 82%. Help?

[lifeisfiction]

I give up. The reported numbers in this field are all over the place. Consider these two links

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

http://www.aidsmap.com/Estimated-risk-per-exposure/page/1324038/

The first is a CDC webpage for the dissemination of information to the lay public. The second is a NAM page.

According to the CDC
"The estimated per act probability of acquiring HIV from an infected source by...receptive anal intercourse is...138 risks out of 10000 exposures"

According to NAM
The HIV transmission risk per exposure by...receptive anal sex amongst gay men, partner HIV positive is...82%.


What am I missing here? Why are these numbers no commensurate? Are they not both measuring the same thing, namely the risk of HIV transmission per exposure via unprotected receptive anal intercourse with an infected partner? According to the CDC the risk is 138 chances of transmission out of 10000 exposures. Even a naive division demonstrates that's way under 2%. According to NAM that same risk is 82%. Help?


Its how the disease is contracted. Just because a person has HIV, it doesn't mean they can always transmit the virus. Its gets so of weird and such so you have to look at the factors. Secondly there is the what should happen and what actually happens and those two numbers are different. Its easier to look at it that when you engage in risky sex you put yourself at high risk. That's all you have to know. So the question I ask is how much do you want to gamble with your health?

[trish]

This is my last post in this thread.


I think.

I hate this field. The lay literature, which is supposed to be sufficiently informative as to allow the public to make intelligent decisions regarding their health and safety, is instead so ambiguous that no intelligent decision making is possible. I have explored several different interpretations of what the lay-literature calls risk and effectiveness and constructed two quick and dirty models based on those understandings. But I not comfortable with any of those under understandings.

The CDC reports the risk of HIV transmission through unprotected receptive anal intercourse with an infected partner is 138 out of 10000 exposures. (http://www.cdc.gov/hiv/policies/law/risk.html)

Most recently I interpreted this to mean that the probability of transmission after ten thousand independent exposures was 138/10000. This would mean the probability of transmission from one exposure was very small.

Here’s a second interpretation: The probability of transmission from one single exposure is 138/10000. It’s not quite the literal translation of the CDC’s statement, but the number (to me) seem much more reasonable: the probability (converted to a percent) of transmission from one single exposure is 1.38% .

I going to construct one more model from this understand (and then give it a rest). The only model considers anal receptive intercourse with an infected partner. It compares PrEP with unprotected intercourse.

The probability of surviving a single exposure without getting infected is 98.62%. So the probability of surviving N exposures without getting infected is (0.9862^N)*100%. So finally the probability (in percentage form) of getting infected sometime during a run of N independent exposures is 100 - (0.9862^N)*100. It’s that simple. That’s the model.

If you have sex 1.5 times daily with an infected partner, then the probability of getting infected during the course of one year (that would be 550 exposures) is 100-(0.9862^550)*100 = 99.95%. Not good.

Does PrEP help? According to CDC “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.” (http://www.cdc.gov/hiv/basics/prep.html)

The risk per exposure (as we now are interpreting it) without protection is .0138. 92% of that would be 0.012696. The number that is 92% lower than .0138 is therefore 0.0138-0.012696= .001104. In percentage form that rounds to 0.11%. To summarize: the probability of transmission through a single exposure without protect is 1.38% whereas the probability of transmission through a single exposure when using PrEP is 0.11%. That’s a significant improvement. Therefore, you’re using a PrEP, then probability of avoiding infection through a single exposure is 99.89%.

Let go back to the example where you have sex 1.5 times daily with an infected partner. This time suppose you’re on a PrEP. Then the probability of getting infected during the course of one year (that would be 550 exposures) is 100-(0.9989^550)*100 = 45.41%. Better. But not good.

I cannot find per exposure numbers on the effectiveness of condoms. Let p denote the probability of transmission during a single exposure with an infected partner.

Then if one uses both a PrEP and a condom the probability of transmission through a single exposure is .0011*p; i.e. the probability that both preventative measures fail at the same time. So the probability that one is not infected is 1-.0011*p. The probability of avoiding transmission given N exposures is (1-.0011*p)^N. In particular the probability of surviving a years worth of exposures (during which you’re having sex with a HIV partner an average of 1.5 times daily) is (1-.0011*p)^550. Even if p were as high as 10%, the probability of no transmission by year’s end (in percentage form) would be 94.13%. The probability of transmission by year’s end is therefore 5.87%. So even if the probability of transmission during one exposure using a condom alone were as high as 10%, condom use would significantly amplify the protection afforded by a PrEP.


So now I’ve presented three fairly divergent probabilistic models HIV infection based on different possible interpretations of the ambiguous lay literature...in particular different interpretations of “effectiveness” and “risk per exposure”.

Model 1: Post 290 (http://www.hungangels.com/vboard/showpost.php?p=1539155&postcount=290) and Post 301 (http://www.hungangels.com/vboard/showpost.php?p=1540807&postcount=301)

Model 2: Post 372 (http://www.hungangels.com/vboard/showpost.php?p=1543784&postcount=372) and Post 373 (http://www.hungangels.com/vboard/showpost.php?p=1543824&postcount=373)

Model 3: This post.

Their divergent conclusions should show I’ve no preconceived biases regarding this issue. I just want to answer the question, “If your life partner infected, what are your chances of acquiring the infection sometime through your relationship.” I’m not in this situation myself. It just seemed like a simple problem that anyone should be able to solve. And it is a simple problem and anyone can easily solve it, given just a few numbers: The probability of HIV transmission from a single exposure (dependent on the type of exposure) and the effectiveness per exposure of the various preventative measures available. I have not solved this problem to my satisfaction because I do not know how to find the probability of HIV transmission given a single exposure. I should probably look into the professional literature, but I rather not spend that kind of time. Besides...I'm too embarrassed to continue. (It may look like I’ve already spent some time on this, but not really. It takes more time to write the posts than it does to make the models.)

[Tapatio]

when you engage in risky sex you put yourself at high risk. That's all you have to know. So the question I ask is how much do you want to gamble with your health?

This. And no amount of prophylaxis will protect against risky behavior.

I'm still not convinced that people will take Truvada correctly just because it's important. People with TB- which can also kill- are so bad about taking pills that antibiotics which cured TB in the past are useless against strains that now show resistance to multiple drugs.

Truvada-resistant variants of HIV-1 have already been found. With inconsistent (yet still detectable) use, effectiveness drops to 42%. Effectiveness against a resistant strain, I assume, is zero.

These are currently decent treatments. We shouldn't treat them like charms against risk.

That's how we get SuperClap™.

[Westheangelino]

This. And no amount of prophylaxis will protect against risky behavior.

I'm still not convinced that people will take Truvada correctly just because it's important. People with TB- which can also kill- are so bad about taking pills that antibiotics which cured TB in the past are useless against strains that now show resistance to multiple drugs.

Truvada-resistant variants of HIV-1 have already been found. With inconsistent (yet still detectable) use, effectiveness drops to 42%. Effectiveness against a resistant strain, I assume, is zero.

These are currently decent treatments. We shouldn't treat them like charms against risk.

That's how we get SuperClap™.


You're an idiot. Do you know how many people get TB out of 325+ million in this country?????????????????? Really????????????? That's your comparison?

[Prospero]

Good old westheangelino has found a new cause to trumpet - in support of his passion - after months of proclaiming the joy of Poppers. And of barebacking. Stay well Wes....

[trish]

This post continues the development of Model 3 in Post 381 (http://www.hungangels.com/vboard/showpost.php?p=1544256&postcount=381).

Why Model 3? Because (given the clarification in http://www.cdc.gov/hiv/basics/prep.html ) Model 1 obviously gets the interpretation of “effective” wrong. Model 2’s interpretation of “risk per exposure” is way to rosey (e.g. p = .0000013896). Indeed, I called this a risky calculation in Post 372 (http://www.hungangels.com/vboard/showpost.php?p=1543784&postcount=372) because I was wary of the interpretation.

What does Model 3 have going for it?
The interpretation of risk per exposure is straightforward. The CDC reports the risk of transmission for unprotected anal receptive intercourse with an HIV infected partner is 138 per 10000 exposures. Model 3 simply interprets this as: the probability of transmission through one exposure is 138/10000 = 0.0138 = 1.38%. Initially I didn’t go with this interpretation and invented Model 2 instead. Why? Because under this interpretation the probability of transmission after 10000 independent exposures is not 138 chances out of 10000. It was stupid of me to expect it should be. All that one can expect is that 138 be the expected number of transmissions given 10000 independent exposures. And indeed
According to Model 3 the expected number of transmission given 10000 independent exposures 138 (the number measured by the CDC).

So what’s left to do with Model 3 is make a predictive theoretical comparison of PrEP use without condoms to its use with condoms.

The effectiveness of condoms against the transmission of HIV is estimated as being somewhere between 90% to 95% (http://www.ncbi.nlm.nih.gov/pubmed/9141163) Let’s take the average and round down to 92%. This number just happens to be the effectiveness of PrEP as well (http://www.cdc.gov/hiv/basics/prep.html).

We saw in my last post that in the case of receptive anal intercourse with an HIV infected partner the probability of transmission through a single exposure for a person using PrEP alone is 0.11%.

Since both PrEP and Condoms have comparable effectiveness against HIV (both 92%) we can also say that in the case of receptive anal intercourse with an HIV infected partner the probability of transmission through a single exposure for a person using condoms alone is 0.11%.

To make Wes happy we’ll also consider the possibility that Truvada(which is a PrEP) is 99% effective. So let’s see, 1.38 is 99% lower than 138. So (using Wes’s report that Truvada is 99% effective) the risk of transmission (for anal receptive intercourse with an HIV partner) is 1.38 per 10000 exposures; i.e. 0.0138%.

For concreteness, once again suppose there are 100 people, each one with a life-long HIV infected partner with whom they have anal receptive intercourse once or twice a day (say 550 times a year).

If the group is on PrEP alone, then after y years the expected number of infected persons is 100[1-(1-.0011)^(550*y)].

If the group is on Wes’s Truvada alone, then after y years the expected number of infected persons is 100[1-(1-.000138)^(550*y)].

If the group is on PrEP and Condoms, then after y years the expected number of infected persons is 100{1-[1-(0.0011)*(0.0011)]^(550*y)}.

Since we’ve been through this a dozen times before I’ll just give a very brief explanation of the last of these. The probability that both the PrEP and the condom fail on the same single exposure is the product of their independent probabilities of failure; i.e. (0.0011)*(0.0011). So [1-(0.0011)*(0.0011)] is the probability that there is no transmission on a single exposure. Consequently [1-(0.0011)*(0.0011)]^(550*y) is the probability of no transmissions after y years. So 1-[1-(0.0011)*(0.0011)]^(550*y) is the probability of at least one transmission before y years are up. Multiply by the group size, in this case 100, to get the expected number of transmission. That’s the quick derivation of the third equation.

So let’s take a look at them. They’re graphed below. Neither form of protection works very well alone. Doubling up a PrEP with condoms has better promise. Condoms can significantly amplify the effectiveness of whatever else you’re using.

Some further points:
Condoms separate the HIV virus from exposure to the PrEP thereby minimizing the risk to the general population of creating resistant strains.

Condoms protect against other STDs as well.

PrEP may have side effects.

Okay. Done. That's my story and I'm stickin' to it.

[Tapatio]

You're an idiot. Do you know how many people get TB out of 325+ million in this country?????????????????? Really????????????? That's your comparison?

The comparison was of MDR (threats multi drug resistant) strains, not of transmission rates.

You missed the entire point of the post because of a failure to understand one sentence.

I'll reserve my assessment of your faculties, though.

[MrBest]

This. And no amount of prophylaxis will protect against risky behavior.

I'm still not convinced that people will take Truvada correctly just because it's important. People with TB- which can also kill- are so bad about taking pills that antibiotics which cured TB in the past are useless against strains that now show resistance to multiple drugs.

Truvada-resistant variants of HIV-1 have already been found. With inconsistent (yet still detectable) use, effectiveness drops to 42%. Effectiveness against a resistant strain, I assume, is zero.

These are currently decent treatments. We shouldn't treat them like charms against risk.

That's how we get SuperClap™.truvada has side effects

[fred41]

truvada has side effects

I'm not sure side effects would be a major deterrent. I think cost would be though.
We live in a world where, genetic predispositions aside, we have people taking tons of medications... to lower cholesterol, fight type 2 diabetes, lower blood pressure, kill all types of pain ...sometimes minor, when often all it would take is to make simple lifestyle changes such as eating right and exercising.
Hell...I'm sure some of the folks on this site still smoke cigarettes and drink til their livers burst.
(I used to know a dude that had such a fear of HIV that , even though he wasn't getting laid on his own, he would refuse to even consider seeing an escort out of fear. He'd rather not have sex...even though he never stopped talking about it...and he smoked like three packs a day...lol)

Condoms are great. They form a barrier that, when used properly, keep out most bugs....but not everyone can use them. If you can't use them, then your only other option is to simply stop having insertive sex with another human being...or form a monogamous relationship whether you really want to or not.

this may be another answer. I'm not sure I would trust it yet,...probably not. Maybe wait and see some more results...but it could be.

I guess my point of this babbling is - everyone can argue their positions til they're blue in the face, but at the end of the day, how we fuck is a personal decision and proselytizing probably wont change what we do in the bedroom. Everyone's head ticks differently.

It's a good debate though, and there are things to learn from it.

[Westheangelino]

This post continues the development of Model 3 in Post 381 (http://www.hungangels.com/vboard/showpost.php?p=1544256&postcount=381).

Why Model 3? Because (given the clarification in http://www.cdc.gov/hiv/basics/prep.html ) Model 1 obviously gets the interpretation of “effective” wrong. Model 2’s interpretation of “risk per exposure” is way to rosey (e.g. p = .0000013896). Indeed, I called this a risky calculation in Post 372 (http://www.hungangels.com/vboard/showpost.php?p=1543784&postcount=372) because I was wary of the interpretation.

What does Model 3 have going for it?
The interpretation of risk per exposure is straightforward. The CDC reports the risk of transmission for unprotected anal receptive intercourse with an HIV infected partner is 138 per 10000 exposures. Model 3 simply interprets this as: the probability of transmission through one exposure is 138/10000 = 0.0138 = 1.38%. Initially I didn’t go with this interpretation and invented Model 2 instead. Why? Because under this interpretation the probability of transmission after 10000 independent exposures is not 138 chances out of 10000. It was stupid of me to expect it should be. All that one can expect is that 138 be the expected number of transmissions given 10000 independent exposures. And indeed
According to Model 3 the expected number of transmission given 10000 independent exposures 138 (the number measured by the CDC).

So what’s left to do with Model 3 is make a predictive theoretical comparison of PrEP use without condoms to its use with condoms.

The effectiveness of condoms against the transmission of HIV is estimated as being somewhere between 90% to 95% (http://www.ncbi.nlm.nih.gov/pubmed/9141163) Let’s take the average and round down to 92%. This number just happens to be the effectiveness of PrEP as well (http://www.cdc.gov/hiv/basics/prep.html).

We saw in my last post that in the case of receptive anal intercourse with an HIV infected partner the probability of transmission through a single exposure for a person using PrEP alone is 0.11%.

Since both PrEP and Condoms have comparable effectiveness against HIV (both 92%) we can also say that in the case of receptive anal intercourse with an HIV infected partner the probability of transmission through a single exposure for a person using condoms alone is 0.11%.

To make Wes happy we’ll also consider the possibility that Truvada(which is a PrEP) is 99% effective. So let’s see, 1.38 is 99% lower than 138. So (using Wes’s report that Truvada is 99% effective) the risk of transmission (for anal receptive intercourse with an HIV partner) is 1.38 per 10000 exposures; i.e. 0.0138%.

For concreteness, once again suppose there are 100 people, each one with a life-long HIV infected partner with whom they have anal receptive intercourse once or twice a day (say 550 times a year).

If the group is on PrEP alone, then after y years the expected number of infected persons is 100[1-(1-.0011)^(550*y)].

If the group is on Wes’s Truvada alone, then after y years the expected number of infected persons is 100[1-(1-.000138)^(550*y)].

If the group is on PrEP and Condoms, then after y years the expected number of infected persons is 100{1-[1-(0.0011)*(0.0011)]^(550*y)}.

Since we’ve been through this a dozen times before I’ll just give a very brief explanation of the last of these. The probability that both the PrEP and the condom fail on the same single exposure is the product of their independent probabilities of failure; i.e. (0.0011)*(0.0011). So [1-(0.0011)*(0.0011)] is the probability that there is no transmission on a single exposure. Consequently [1-(0.0011)*(0.0011)]^(550*y) is the probability of no transmissions after y years. So 1-[1-(0.0011)*(0.0011)]^(550*y) is the probability of at least one transmission before y years are up. Multiply by the group size, in this case 100, to get the expected number of transmission. That’s the quick derivation of the third equation.

So let’s take a look at them. They’re graphed below. Neither form of protection works very well alone. Doubling up a PrEP with condoms has better promise. Condoms can significantly amplify the effectiveness of whatever else you’re using.

Some further points:
Condoms separate the HIV virus from exposure to the PrEP thereby minimizing the risk to the general population of creating resistant strains.

Condoms protect against other STDs as well.

PrEP may have side effects.

Okay. Done. That's my story and I'm stickin' to it.


Wrong. Condoms and Truvada are both effective on their own. THEIR EFFICACY IS BASED ON HOW WEL YOU USE THEM. NO MORE, NO LESS.

[trish]

Wrong. Condoms and Truvada are both effective on their own. THEIR EFFICACY IS BASED ON HOW WEL YOU USE THEM. NO MORE, NO LESS.Where did I say 92% is not effective? Where did I say that proper and consistent use was not essential in their application. But effectiveness is not a guarantee that one will remain infection free throughout an extended period of use. Those who engage in risky behaviors for longer periods of time are more likely to reap the ill effects of such behavior. Therefore, it behooves those who find themselves confronting an extended period of time engaged therein to coldly consider the probabilities of infection over time (or equivalently over the number of exposures).

Below in chart form is a comparison of the probabilities of HIV transmission. One curve is for a subject using PrEP alone while engaged in receptive anal intercourse with an HIV infected partner for an extended number of exposures. Another curve is for a subject using PrEP alone while engaged in insertive anal intercourse with an HIV infected partner for an extended number of exposures. Another curve illustrates the probability of HIV transmission to a subject using PrEP+Condoms while engaged in receptive anal intercourse with an HIV infected partner for an extended number of exposures. Finally there is a curve describing the same for subject using PrEP+Condoms while engaged in insertive anal intercourse with an HIV infected partner for an extended number of exposures. (Just for reference, if you have sex with an HIV infected partner once or twice a day for average of 550 times a years for 40 years, that amounts to 22000 exposures. The chart goes up to 30000 exposures) Two of the curves quite obviously asymptotically approach a 100% certainty of transmission. Of course the other two curves approach the same asymptote. This is just an expression of the fact already stated, namely that Those who engage in risky behaviors for longer periods of time are more likely to reap the ill effects of such behavior. The crucial question is how quickly do the curves rise. Those two corresponding to a double use of PrEP+Condoms rise most slowly. Indeed the insertive anal curve for PrEP+Condom (red) barely rises to visibility over 30000 exposures!

To help anyone who would like to criticize this model and it’s conclusions, I make all of it’s assumptions explicit in one place...this post.

The model is based upon:

1 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.

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

[Westheangelino]

Because your bullshit graphs convey the following message to people: fuck long enough (either using condoms or Truvada), and HIV infection is inevitable. Pure bullshit

[kaientai]

Because your bullshit graphs convey the following message to people: fuck long enough (either using condoms or Truvada), and HIV infection is inevitable. Pure bullshit

Yeah but your talking like Truvada is the end all to HIV wich it is not, the way to take it etc.. You are going to trust someone who says he/she takes it daily? Even if you are taking it you are a long way away from being 100% Safe. No offence Wes

[Westheangelino]

Yeah but your talking like Truvada is the end all to HIV wich it is not, the way to take it etc.. You are going to trust someone who says he/she takes it daily? Even if you are taking it you are a long way away from being 100% Safe. No offence Wes

It IS the end. Your whole statement is assinine. The only person you need to trust is yourself!!! get on it, stay on it, stay negative

[trish]

Because your bullshit graphs convey the following message to people: fuck long enough (either using condoms or Truvada), and HIV infection is inevitable. Pure bullshit
If you were immortal and exposed yourself to HIV infection long enough, yes...then transmission is inevitable, regardless of what protections you use. But we aren't immortal and some of those graphs are very slow risers (those illustrating PrEP use WITH CONDOMS barely get above 0.0355 in a lifetime of normal sex with an HIV partner.

The bullshit that's being peddled in this thread is that the effectiveness of Truvada would be 100% were it used consistently as directed. Truvada can be UP TO 92% EFFECTIVE PROVIDED IT IS USED AS DIRECTED. According to the CDC...

"Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection. When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently.
PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months." http://www.cdc.gov/hiv/prevention/research/prep/
-
Ninety-two percent effective only means it lowers the unprotected risk of protection by 92% The CDC puts the risk of unprotected insertive anal sex with an HIV partner at 11/10000. 92% lower is 0.88/10000. That's not bad. If you're using Truvada as directed your probability of avoiding HIV transmission through a single anal insertive exposure with an infected partner is 0.999912. The probability you will avoid infected should you expose yourself twice is (0.999912) times (0.999912). This works out to be 0.999824. A decade of anal insertive sex with an HIV infected partner may entail as many as 5000 exposures (figuring one or two exposures daily). The probability of non-transmission during a run of 5000 exposures is (.999912) times itself 5000 times. That works out to 0.644; i.e. there a 35.6% chance that you'll be infected by decade's end.

[kaientai]

It IS the end. Your whole statement is assinine. The only person you need to trust is yourself!!! get on it, stay on it, stay negative

Wes it is not and I did no mean to be assinine but you are putting to much trust in this. Even if you take it daily the way it is intended to (meaning on a regular time with food) on a bad day (just a little flu for instance) you can still catch or give this terrible thing

[lifeisfiction]

Let us all not forgot. Not every person has HIV and just because a person has HIV does not mean it can be contracted. If a person exercise common sense and diligence in choosing partners, practices safe sex methods or remains in a sole relationship where neither partner has HIV, you chances of getting is extremely low to nill. I think we tend to forget the real world facts is some people who have contracted HIV have engaged in unsafe sex practices putting them at high risk for transmission. I do like Trish's analysis, but we must remember it is our decisions sometimes can lead us into trouble.

From what I have been gleaning Truvada was pushed for high risk people, those who will not use protection. Most people who exercise care are not getting HIV, but there is a subsection of people (and its increasing) who don't care for condom use, do not get tested regularly assuming they have nothing or are occasionally lax on their safe sex practices. These are the people who are at risk for HIV.

[Westheangelino]

Wes it is not and I did no mean to be assinine but you are putting to much trust in this. Even if you take it daily the way it is intended to (meaning on a regular time with food) on a bad day (just a little flu for instance) you can still catch or give this terrible thing


What are you even talking about???? The flu??? What have you read suggesting that influenza inhibits Truvada's efficacy??? And how does an HIV negative person on Truvada "give this terrible thing?"

[Teydyn]

Looks like i had it right (http://www.hungangels.com/vboard/showthread.php?p=1542741#post1542741). Wes doesnt care about math.


Because your bullshit graphs convey the following message to people: fuck long enough (either using condoms or Truvada), and HIV infection is inevitable. Pure bullshit
That is exactly what the CDC numbers tell you. With a set chance of infection per year/encounter (even a miniscule one) your chance to catch it rise over the years. Honing in on 100% over a long time. (this time might be longer then a human lives, but a chance of 36% over a decade is nothing to sneeze at)

Trish showed the math. Easy math. Maybe she got the numbers wrong, but unless there is a 0% chance of infection the idea behind it stays. Why dont you go and give her the "real" numbers instead of saying "bullshit, you lie, truvada is 100% safe" even though there are many numbers that claim the opposite?


And how does an HIV negative person on Truvada "give this terrible thing?"
Might it be he was talking about someone positive on truvada? Just maybe? Then the sentence makes sense?

[Tapatio]

It IS the end. Your whole statement is assinine. The only person you need to trust is yourself!!! get on it, stay on it, stay negative

Truvada. Resistant. Strains.

They exist. Truvada is not the end of HIV.

Wes, wishing won't make it so.

[dreamon]

Truvada. Resistant. Strains.

They exist. Truvada is not the end of HIV.

Wes, wishing won't make it so.

No dude this is literally a cure for HIV, the evil pharmaceutical companies just are suppressing the truth.

[Tapatio]

No dude this is literally a cure for HIV, the evil pharmaceutical companies just are suppressing the truth.


Dude, you have it backwards. The conspiracy is in Big Pharma, man.

Secretly, they are irradiating Truvada users, letting the (mostly harmless) dose build up daily- ever wonder why they're SSSSOOOOOO insistent you take it every day?- and when the radiation has built to sufficient levels and can be monitored by roving vans equipped with huge Geiger counters, they start hunting.

When they find enough "Truvada whores" (that's what the company calls them- and I say "company" but it's obviously an extension of the Illuminati) in one place, they send an extraction team.

It's efficient, they found, to go after groups. Unless you do home invasion, which has its own special risks like alarms, higher incidence of firearms, etc., snatching one person involves as many witnesses as snatching a bunch. Not to mention the economies of scale (sure, it's a global conspiracy, but these are businessmen.)

The TWs are shipped to the FEMA camps that the tin foil brigade keeps insisting exists and indoctrinated through a grueling mashup of MK Ultra tactics and Navy SEAL training. After approximately 10 weeks (nobody knows for sure- the TWs aren't talking and we can only measure when they were last seen to when they first reappear.

Buff, overconfident from the programming, completely shameless, and unable to reconcile anything that conflicts with their indoctrination, they cruise the clubs at major cities, picking up ass and proselytizing to create more TWs until the company calls them.

Once activated and given a target, they are the most ruthless and effective assassins the world has ever known. Total Weapons. They accomplish in bars and beds what the company can't in voting booths and boardrooms.

Y'all best stop fucking with Wes. That's all I'm saying.

[Westheangelino]

Dude, you have it backwards. The conspiracy is in Big Pharma, man.

Secretly, they are irradiating Truvada users, letting the (mostly harmless) dose build up daily- ever wonder why they're SSSSOOOOOO insistent you take it every day?- and when the radiation has built to sufficient levels and can be monitored by roving vans equipped with huge Geiger counters, they start hunting.

When they find enough "Truvada whores" (that's what the company calls them- and I say "company" but it's obviously an extension of the Illuminati) in one place, they send an extraction team.

It's efficient, they found, to go after groups. Unless you do home invasion, which has its own special risks like alarms, higher incidence of firearms, etc., snatching one person involves as many witnesses as snatching a bunch. Not to mention the economies of scale (sure, it's a global conspiracy, but these are businessmen.)

The TWs are shipped to the FEMA camps that the tin foil brigade keeps insisting exists and indoctrinated through a grueling mashup of MK Ultra tactics and Navy SEAL training. After approximately 10 weeks (nobody knows for sure- the TWs aren't talking and we can only measure when they were last seen to when they first reappear.

Buff, overconfident from the programming, completely shameless, and unable to reconcile anything that conflicts with their indoctrination, they cruise the clubs at major cities, picking up ass and proselytizing to create more TWs until the company calls them.

Once activated and given a target, they are the most ruthless and effective assassins the world has ever known. Total Weapons. They accomplish in bars and beds what the company can't in voting booths and boardrooms.

Y'all best stop fucking with Wes. That's all I'm saying.

And guess what? ALL THOSE TRUVADA WHORES WILL BE HIV -!!!!!

[trish]

...Not every person has HIV and just because a person has HIV does not mean it can be contracted. If a person exercise(s) common sense and diligence in choosing partners, practices safe sex methods or remains in a sole relationship where neither partner has HIV, you chances of getting is extremely low to nill.....
Indeed. The model which I posted is in one sense a worst case scenario; i.e. someone who loves and plans to be in a long term relationship with a HIV infected partner. It uses the CDC’s maximum 92% efficiency for PrEP and assumes the same for condoms. It does not take into account the likelihood that the partner may be on medications that reduce the concentration of the HIV virus in his blood. In the chart I posted the word “exposure” means intercourse with an HIV infected person...not just a random person who may or may not have be infected with the virus. If you have sex one or two times a day with an infected partner, thats about 500 to 550 exposures a year...maybe 22000 over a lifetime. If you only ever have sex with one uninfected person, that’s zero exposures over a lifetime. A sex-worker might have 30000 to 40000 exposures in a lifetime. Your expected number of lifetime exposures to HIV is equal to your expected number of sexual encounters times the probability that any given encounter is with a HIV infected person. The latter number will vary with date and location.

[Westheangelino]

^ Trish, that's the first sensible thing you've said ;)

[nysprod]

Lol...I'm 100% anal insertive lmao

[trish]

^ Trish, that's the first sensible thing you've said ;)
It's not contrary to what I've said before. Notice the chart is the same. I'm simply giving more context to help people apply the chart to their own situations.

[Westheangelino]

^ That's my point. In the past you've used the chart to scare people from taking truvada. Now, it seems as though you're back tracking like everyone else does when they find out that this drug actually works!!!!

[trish]

Bullshit Wes. I never said don't take truvada or use a PrEP. From the charts alone it would appear my message was for the most efficient protection use a PrEP together with Condoms.

If a person feels their risk is such that it's worth looking into using a PrEP, then that person should be aware that 1) condoms (if used consistently) have about the same efficiency against the transmission of HIV as do PrEPs; 2) condoms protect against a multitude of other STDs; 3) PrEPs have side effects that users should keep an eye on; 4) if you suspect you have a high exposure rate, then PrEP and Condoms Together give significantly better protection (see the chart in post #403 http://www.hungangels.com/vboard/showpost.php?p=1547949&postcount=403 ) than either method of protection alone.

None of these points should dissuade anyone from using trying PrEPs. Just, if you use a PrEP, use it as directed, use it with caution (get regular check ups to keep an eye out for possible unwanted effects of longterm use), and consider whether your rate of exposure to HIV and to other STDs are high enough to warrant the use of a condom as well.

[Westheangelino]

^ PrEP alone is more effective than condoms alone. Also, if you are on the medication you are REQUIRED to take an HIV test every three months.

[Westheangelino]

http://www.towleroad.com/2014/11/research-on-injectable-longer-lasting-prep-moving-forward.html


^ Soon, PrEP will be a long lasting injectable!

[Tapatio]

I'd like to point out again that the effectiveness number Wes is holding onto is based on PERFECT treatment with the drug.

Used imperfectly, Truvada is much less effective than condoms and (given the bias toward high risk partners- why else bother with Truvada?) counting on this pill alone to take care of your health is pretty stupid.

[Westheangelino]

That just simply isn't true. Even people who only took the drug four times a week never became infected. Your statements only reiterate the stupidity of arguments against Truvada but for condoms. You expect people to put a piece of rubber on their dick every time they have sex but not to take a pill every day?

[lifeisfiction]

That just simply isn't true. Even people who only took the drug four times a week never became infected. Your statements only reiterate the stupidity of arguments against Truvada but for condoms. You expect people to put a piece of rubber on their dick every time they have sex but not to take a pill every day?

Fun fact about condoms, they protect against other stds. While you may think there is nothing to worry about there is such a thing as super gonorrhea an almost near impossible disease to cure.

And by the way, a drug is not effective enough if you do not have the proper dosage in your system. So when you miss taking the drug you increase risk. The drug with condoms provides ease and peace of mind.

But according to West, condoms are the most evil device in the world. It takes away all the pleasure. I really wonder West why so against condoms. I mean can't you enjoy sex with a condom?

Pray tell West, are you advocating that we can all start having tons of bareback sex with strangers?

[Tapatio]

That just simply isn't true. Even people who only took the drug four times a week never became infected.

You find 47% effectiveness acceptable? That is the number I read for the "less than perfect" group.

[Westheangelino]

No. I do not enjoy sex with condoms.

BRING BACK BATH HOUSE CULTURE

[Tapatio]

No. I do not enjoy sex with condoms.



We did divine this, of course.

[lifeisfiction]

No. I do not enjoy sex with condoms.

BRING BACK BATH HOUSE CULTURE

So you go to bath houses, hmmmm its finally starting to make sense.

[Westheangelino]

^ No I don't, actually. They aren't fun nowadays. I'm really just trolling with the last post ;)

[lifeisfiction]

So if you aren't going there where is the action? Of course I know you were attempting to troll my last post, but you left yourself wide open.

[Westheangelino]

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

[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 BULLSHITGood, 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.

[BBaggins06]

Y'all might as well be arguing with a conservative Republican about abortion or birth control or anything really. No amount of logic, science or math is going to change their minds ...

[Teydyn]

Trish, your graphs are BULLSHIT
They arent. Unlike your nonexisting understanding of math...


Or common sense

[Westheangelino]

Use truvada

[Tapatio]

Use truvada

Billions of people say "no."

Out of curiosity, did you know that many companies pay internet shills for this kind of thread?

[Westheangelino]

^ Billions of people have no idea it exists. I'd be very curious to see a poll (I'm sure we will see it soon) of young gay men and transfolk to see how many of them even know what Truvada is. Also, those who do know what it is, what is their understanding of it? Is it factual in any way?

[Westheangelino]

https://www.youtube.com/watch?v=u1WsKvPPZjQ

^I'm just as worried about this happening. If the AHF and other groups like it are sooooo concerned that people aren't going to use Truvada correctly, then why not actually educate them about it rather than spreading lies and disinformation?

[lifeisfiction]

https://www.youtube.com/watch?v=u1WsKvPPZjQ

^I'm just as worried about this happening. If the AHF and other groups like it are sooooo concerned that people aren't going to use Truvada correctly, then why not actually educate them about it rather than spreading lies and disinformation?

What are you talking about? You think Gilead would not want people know of their product. Ever since Pharmaceutical companies are allowed to advertise to the public directly they are just going to simply throw out their cash cow product without any information. You've got to be kidding me. They have gone to work and in fact I saw this as my YouTube commercial (YouTube stop with all the commercials) https://www.youtube.com/watch?v=odzWBe8h5-A&list=UUuelBFEU4Olmtn2oejnWIOw.

In addition, how will people know that a person is using a product correctly. At least with condoms and Truvada you have knowledge that a least one of them will be used correctly.

[MrsKellyPierce]

To the ones attacking the porn industry when is the last time you had a full panel std test including hepc/a/b etc???

Yawn...people talk a whole bunch of shit yet probably have one night stands on the regular, cheat on their wives/gfs, and maybe test when their scared, once a year, or NEVER due to being scared of what it will say...

[MrsKellyPierce]

As far as Truvada goes it is approved by the FDA as are many drugs that have serious side effects on certain people that take them.

What we should be happy about though is we are getting closer to preventing/curing HIV and someone mentioned the new Hep C drug Sovaldi that cures over 89% of patients...we are getting closer to attacking these STDS and turning them into the chlamydia and ghonnera or maybe even some day have a vaccine we take...

However truvada does seem still like a risky drug to take especially for transsexuals who pump hormones into their body.

[Westheangelino]

As far as Truvada goes it is approved by the FDA as are many drugs that have serious side effects on certain people that take them.

What we should be happy about though is we are getting closer to preventing/curing HIV and someone mentioned the new Hep C drug Sovaldi that cures over 89% of patients...we are getting closer to attacking these STDS and turning them into the chlamydia and ghonnera or maybe even some day have a vaccine we take...

However truvada does seem still like a risky drug to take especially for transsexuals who pump hormones into their body.

There is no evidence that Truvada in conjunction with hormones would have any ill effect.

[TSLoverIB]

http://www.nytimes.com/2014/11/17/upshot/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html?_r=1&abt=0002&abg=1

[Westheangelino]

^ Word

[Westheangelino]

Such a great article!

http://www.thestranger.com/seattle/the-case-for-prep-or-how-i-learned-to-stop-worrying-and-love-hiv-positive-guys/Content?oid=20991643

[trish]

Know your exposure. Know your risks. If your behavior is high risk, then along with whatever else you use, use condoms.

[kaientai]

Last time i post in this, will this pill help yes if taken properly is it 100% no way, Wes can post all the links he likes but there is not a definitive number here also the side affects are real so if you have liver issues be careful with this pill. But if you want to fuck bare go right ahead. I just dont understand I gues

[Westheangelino]

http://thegavoice.com/truvada-new-morning-pill/

A new trial suggests that Truvada is even effective if it is taken the day or and the morning after some delicious natural sex!

[Tapatio]

Last time i post in this, will this pill help yes if taken properly is it 100% no way, Wes can post all the links he likes but there is not a definitive number here also the side affects are real so if you have liver issues be careful with this pill. But if you want to fuck bare go right ahead. I just dont understand I gues

I think you understand perfectly- that seems a decent summary.

[dreamon]

http://thegavoice.com/truvada-new-morning-pill/

Ronnie Bass, executive director of HIV/AIDS outreach organization Someone Cares, who also warns, “It’s not a Band-Aid toward having unprotected sex."

[Westheangelino]

I'd just like to give a fresh update to this topic:

I'll be participating in a year long Truvada study as of today! Went in for my pre-screening and came up negative! First step complete. In about two weeks I'll have my Truvada!

Today I had the opportunity to talk to researchers and Dr.'s themselves, and I would like to point something out about the IPREX study that has been discussed, debated, and misconstrued in this thread. They pointed out to me that during the study, they were able to isolate those who took their pills on a daily basis (this was accomplished by measuring drug levels in the blood) and discover that unlike the rest of the cohort that did not follow their regimen so closely, 99% OF THESE MEN AVOIDED HIV INFECTION. So, once and for all, that should lay to rest where I got the 99%.

[Tapatio]

About time your hard work paid off- do you get a discount based on post numbers?

Seriously, I hope it's what you want and works for you- but your last post points to a problem again.

These results are based on perfect usage. With perfect conditions condoms are just as effective, cheaper, and protect against a host of other diseases.

Please don't get the herps or something, Wes.

[Westheangelino]

^ It's a study run through a prominent University. I'm not being paid through Gilead.

Also, how hard is it really to take the pill every day? I'll say it again: we trust women to do the same with something that has worse side effects merely to ward off pregnancy. We don't trust men to take a pill every day to ward off a deadly disease? What does that say about how we view ourselves and each other?

Clearly you didn't read my previous few posts about how a new study suggests strongly that taking the pill the day of and day after a possible exposure is just as effective. That remains to be seen, and the study I'm participating in will not be looking into that.

As far as effectiveness: condoms, when used perfectly (which is rarely) are only 95% effective. Truvada is 99% effective and far easier to adhere to. Also, studies suggest that it reduces your chance of getting herpes by 35%. Condoms are NOT effective against herpes. AT ALL

[Westheangelino]

After many months on the wait list, I am finally receiving free Truvada through a study!!!!!!

Been on it for four days and have no side effects to speak of.

[lifeisfiction]

Wish you the best. Side effects won't pop up for a while. Now the question I have to ask, are you going to play it safe and use condoms in addition or do you think you will play it by ear?

Cause if you are using condoms for all your sexual interactions, then you don't have to worry about anything really.

[MrBest]

As far as effectiveness: condoms, when used perfectly (which is rarely)
what does that even mean?

[Westheangelino]

Wish you the best. Side effects won't pop up for a while. Now the question I have to ask, are you going to play it safe and use condoms in addition or do you think you will play it by ear?

Cause if you are using condoms for all your sexual interactions, then you don't have to worry about anything really.


Planning on playing it by ear. I prefer it raw, but, for example, I hooked up with someone last night and they wanted to use a condom, so I did.

[lifeisfiction]

Planning on playing it by ear. I prefer it raw, but, for example, I hooked up with someone last night and they wanted to use a condom, so I did.

West say its not so. You are using condoms and Truvada. Now that's a great example of someone playing it safe. Yup, I am not disappointed.

[Westheangelino]

As I've said before, I prefer raw, but I'm not going to walk out the door if the partner wants to wear a condom. If they want that layer of protection, awesome. I just now take comfort that I have a level of protection that works for me and won't make me feel guilty in the morning.

[Westheangelino]

Several weeks in and no side effects! The only side effect I have is a lack of anxiety!

[AdaBlackXXX]

Is he dead yet? :dead:

[Westheangelino]

^ Very much alive. Why the vitriol?

[rodinuk]

BBC News report:

'Give HIV drugs to healthy gay men:Healthy gay men should be offered daily HIV drugs to prevent infections, say UK Medical Research Council and Public Health England scientists.'

http://www.bbc.co.uk/news/health-31601042

[natina]

Pill taken before, after sex may prevent HIV


An HIV prevention pill, called Truvada, taken by gay men before and after sex reduced the risk of virus transmission by 86 percent, according to the results of a clinical trial

An HIV prevention pill taken by gay men before and after sex reduced the risk of virus transmission by 86 percent, according to the results of a clinical trial released Tuesday.
Truvada contains HIV treatment drugs tenofovir and emtricitabine, and is made by Gilead Sciences in California. In the study Truvada was taken up to one day before sex and the two days after.
The study, led by the French National HIV research agency ANRS, was presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.
Until now, Truvada as a preventive measure has been prescribed only as a once-a-day regimen, not one that could be effective if taken around the time of sex.
While the latest evidence on the technique known as pre-exposure prophylaxis, or PrEP, is not enough to change guidelines, it was welcomed as a novel approach to HIV prevention.
The study "provides the first evidence that an event-driven regimen is effective among high-risk MSM (men who have sex with men) with frequent sex," said Jonathan Mermin, director of the US Centers for Disease Control and Prevention's National Center for HIV/AIDS.
Truvada was approved in 2012 by the US Food and Drug Administration as the first daily pill to help prevent human immunodeficiency virus in some high-risk groups.
- Three pills -
The latest trial, called IPERGAY, was a randomized, placebo-controlled study that began in February 2012 and was halted in October 2014 when an independent data safety review board found it had a high rate of effectiveness.
A total of 400 participants were enrolled.
Those in the trial were considered to be at high-risk of acquiring HIV because they were having sex an average of 10 times per month, and with eight partners every two months.
Some participants took a placebo, while others took Truvada two to 24 hours before sex, then again 24 and 48 hours later.
The research team "reported that PrEP reduced HIV risk among the MSM who were prescribed this regimen by an average of 86 percent," according to a statement.
Previous research on Truvada to prevent HIV has found that those who took it regularly could lower their risk of getting HIV by as much as 92 percent.
Most of the men in the study were taking Truvada four days a week, and it remains to be seen if the regimen would be as effective among men having sex less frequently
Mermin cautioned that it remains unknown whether Truvada taken only in the hours before sex and the two days afterward could work in heterosexual men and women, or injection drug users, or outside a tightly controlled trial.
"CDC continues to recommend only daily use of PrEP, as approved by the FDA," Mermin said.
"Daily, oral PrEP is recommended by CDC as an option for men who have sex with men, heterosexual men and women, and injection drug users."

- More PrEP study -
A second study released at CROI by the UK Medical Research Council found that daily oral PrEP using Truvada reduced risk of HIV transmission among gay men by 86 percent.
A third study examined the use of a daily pill to prevent HIV among heterosexual couples in which one person is HIV positive and the other is not.
Led by the University of Washington, the trial underway in Kenya and Uganda is probing the efficacy of PrEP as a transitional strategy, to protect one partner from HIV while the HIV-positive partner gets his or her viral load under control through antiretroviral medication.
"Preliminary results show that this dual strategy reduced the risk of HIV infection by 96 percent," Mermin said.
"These findings together provide encouraging additional evidence of the power of PrEP to reduce the risk of HIV infection."
Since PrEP does not work all the time, nor does it prevent sexually transmitted infections like syphilis and gonorrhea, health authorities say people should continue to use condoms regularly.
Common side effects of Truvada include diarrhea, nausea, abdominal pain, headache and weight loss

http://www.msn.com/en-us/health/medical/pill-taken-before-after-sex-may-prevent-hiv/ar-BBhVBug

[Donkey]

http://www.independent.co.uk/life-style/health-and-families/health-news/hiv-pill-scientists-hail-discovery-of-gamechanger-that-cuts-the-risk-of-infection-among-gay-men-by-86-10068091.html

[lifeisfiction]

Interesting articles. I wonder how many were using Truvada without condoms. Some people still use condoms while on Truvada. This gets more interesting each time. I really want to know the numbers for people who rely on Truvada alone as their main means of protection.

[Westheangelino]

^ Two months in with no side effects!

[fred41]

I actually think once price comes down a bit more, lots of people are going to be on this...but I think right now Gilead is making more money from their Hep C drugs...so they are not actively marketing this drug :
http://www.fiercepharma.com/story/heres-switcheroo-hiv-activists-target-gilead-holding-back-truvada-marketing/2015-02-18

...Best of luck with the drug trial Wes !!

[sukumvit boy]

Here's an update on a new Truvada type drug for those interested .
By the way ,sorry to hear about poster "Westheangelino" ,heard he past away RIP.
https://science.sciencemag.org/content/368/6493/807

[Lorca81]

Interesting articles. I wonder how many were using Truvada without condoms. Some people still use condoms while on Truvada. This gets more interesting each time. I really want to know the numbers for people who rely on Truvada alone as their main means of protection.

In my experience, some PrEP users are pretty cavalier about condom use and feel comfortable bare-backing.

[MrFanti]

Here's an update on a new Truvada type drug for those interested .
By the way ,sorry to hear about poster "Westheangelino" ,heard he past away RIP.
https://science.sciencemag.org/content/368/6493/807

Yes he passed and he was right about a number things - great to see that he stood his ground against all the hostility that he received here for just trying to help us.

[Lorca81]

Yes he passed and he was right about a number things - great to see that he stood his ground against all the hostility that he received here for just trying to help us.

Well said. Lots of comments in this thread are cringy with age.