Condoms and Prep

[youngboldone]

Okay, guys. Hopefully I'm not walking into landmine territory here, but I would like some solid advice. In the past year I have seen three escorts and one erotic masseur. In all cases, the possibility for anal intercourse presented itself. In the case of the masseur, it was with my porn star idol. I was only expecting an erotic massage and didn't think things would go into escort territory, but they did. I, unfortunately and to my eternal regret, was not equipped with a condom. The porn star didn't have one either. He wanted me to top him and told me "it was cool because he was on Prep, so no worries". Well, I'm not on Prep. I've never felt more conflicted in my life. For so many years, I had fantasized about being with this guy, and now here he was offering himself to me. I entered him with maybe 2-3 thrusts before I freaked, pulled out, and said I couldn't do it without a condom.

 

In my other 3 encounters with escorts, I did not engage in anal with one because the connection didn't feel right, didn't with another because I knew going in that he was HIV+ and couldn't relax enough to really trust that it would be safe with a condom, and with the third, I bottomed for him (losing my virginity in the process), and he did wear a condom.

 

Forgive my rambling, but I think what I'm trying to get at is should I get on Prep so that I will feel 100% protected going into future encounters? I would still use condoms even if I were on Prep, so that would be two layers of protection, correct? I'm worried about the side effects and long-term consequences of being on Prep. And yet, I want to be able to enjoy sex without being crippled by the worry surrounding it that has plagued me all my life. I want to be able to relax. Any suggestions?

[+ OliverSaks]

PreP has helped a lot of people worry less. Definitely something to consider.

[rvwnsd]

Truvada as PrEP is one additional tool in the prevention of acquiring the HIV virus. The decision to start using it is very personal and only you can make it. For me, after reading about potential side effects and talking with my physician it was about having that extra tool in my toolkit. I've been using it faithfully for two years and so far the only side effect has been slightly elevated kidney liver values. Considering the side effects associated with one of the asthma medications I take (increased risk of death due to an asthma attack) the Truvada as PrEP side effects are minimal.

 

Now here's where it gets messy and uncomfortable. Based on your various posts, Truvada as PrEP is not the silver bullet that will alleviate your deep-seated and long-term fear of seroconverting. It appears that part of that fear is associated with you pursuing sexual gratification outside of your self-described sexless marriage. No medication will help with that. As long as you understand that there's a decent probability that you will feel some degree of fear, despite using Truvada as PrEP, it could be beneficial to you.

 

My advice: talk to your doctor.

 

EDIT: The elevated values were liver, not kidney.

Edited January 20, 2018 by rvwnsd

[LaffingBear]

1. Get tested to put your mind at ease about your brief bottoming experience.
   
2. If the idea of medication side effects and long term effects concerns you, maybe drugs arent for you. Just go the condom route.
   
3. Fear is a basic human emotion. You can try to address your fear regardless of the protection method chosen.
   

[SuenosAmor]

Some guys experience very minor side effects when they first start taking Truvada. But generally, it's a very well-tolerated drug. I've never experienced any side effects in the 2 years I've been taking it.

 

I would encourage you to get on the Truvada regimen, if you are sexually active and have concerns about contracting HIV. I personally think it's a game changer. If you are with a positive guy who takes his meds regularly and his viral load is undetectable, there is very little chance of getting HIV if you bareback. In fact, these are the least likely men to pass on HIV to another man. Of course, you can still catch everything else, like syphilis, so condoms are still a good idea if you have several partners.

[+ JEC]

Truvada as PrEP is one additional tool in the prevention of acquiring the HIV virus. The decision to start using it is very personal and only you can make it. For me, after reading about potential side effects and talking with my physician it was about having that extra tool in my toolkit. I've been using it faithfully for two years and so far the only side effect has been slightly elevated kidney values. Considering the side effects associated with one of the asthma medications I take (increased risk of death due to an asthma attack) the Truvada as PrEP side effects are minimal.

 

Now here's where it gets messy and uncomfortable. Based on your various posts, Truvada as PrEP is not the silver bullet that will alleviate your deep-seated and long-term fear of seroconverting. It appears that part of that fear is associated with you pursuing sexual gratification outside of your self-described sexless marriage. No medication will help with that. As long as you understand that there's a decent probability that you will feel some degree of fear, despite using Truvada as PrEP, it could be beneficial to you.

 

My advice: talk to your doctor.

I agree with @rvwnsd with one minor caveat, I'd say talk to a (vs. your) doctor - one who you can feel comfortable being open about your situation, this may require finding a new/different doctor. I don't think the escorting detail is important to share, especially since that's illegal, only that you are sexually active with other men (MSM). The science and options for HIV and STIs has changed a lot in just a few years and you could get bad advice/reaction from someone who is not up-to-date or disapproves of your choices. If you live in/near a major city, I'd seek out a doctor who caters to gay men's health. Many of us who lived through the terror of the AIDS crisis live with some amount of PTSD as a result esp. when it comes to sex, which is so sad really. Personally, I'd recommend anyone sexually active get on Prep...whether you consider yourself "safe" or not. There is mounting evidence that it may also prevent Hep B. Best of luck.....

[+ Tarte Gogo]

Forgive my rambling,

No rambling at all, that was very specific and I am glad you are recently opening up to us.

should I get on Prep so that I will feel 100% protected going into future encounters?

You will be protected against HIV, but there are a couple of very common STDs around (chlamydia and gonorrhea) that you can catch. They are very easily treated, once you have them, but still, it is annoying. There isn't a vaccine that you can get against them.

I would still use condoms even if I were on Prep, so that would be two layers of protection, correct?

Yes, you would have 2 layers of protection against HIV, and one against all other STDs.

I want to be able to relax. Any suggestions?

Even if you get on PrEP, bring condoms and lube everywhere you go, you never know when sex can occur!

 

I can't give you first hand side effect experience, as I am not on PrEP, others here can describe what it does to them, but it is clear from the literature that it varies a lot depending on the person. Maybe you can try it for two week and decide only afterwards if it has no significant side effects on you, as many have reported? Ask your doctor : "Just trying PrEP to see what are the side effects before committing to being full time on it".

[escortrod]

You will be protected against HIV, but there are a couple of very common STDs around (chlamydia and gonorrhea) that you can catch. They are very easily treated, once you have them, but still, it is annoying. There isn't a vaccine that you can get against them.

They are usually easily treated, but there are antibiotic resistant strains of gonorreah.

 

Yes, you would have 2 layers of protection against HIV, and one against all other STDs.

One against most other STIs. Some can be transmitted by skin contact.

[+ Tarte Gogo]

They are usually easily treated, but there are antibiotic resistant strains of gonorreah.

 

Oh, yeah, I was forgetting, I read about this. I have no idea how common this strain is, though, it is now becoming a genuine risk, or still a rarity?

 

 

One against most other STIs. Some can be transmitted by skin contact.

I wonder why they are classified as "sexually transmitted" then. If they are transmitted even before you even have sex, just by touching, then they are just "normally transmitted".

Edited January 18, 2018 by Tarte Gogo

[escortrod]

Oh, yeah, I was forgetting, I read about this. I have no idea how common this strain is, though, it is now becoming a genuine risk, or still a rarity?

It's a rarity, but it is becoming more common, especially amongst MSM.

I wonder why they are classified as "sexually transmitted" then. If they are transmitted even before you even have sex, just by touching, then they are just "normally transmitted".

Because they're typically transmitted during sexual touching of some sort, e.g. mouth to genital or genital to genital contact. Genital warts would be a primary example. There are condoms with flared bases that minimise skin to skin contact during intercourse, but I'm the only person I know who has ever used them.

[KennF]

Two things:

1) Put a condom in your wallet and leave it there for those moments when things "occur" with spontaneity. You'll never again have to say, we can't have sex because we don't have a condom. Most men that I know, have one with them permanently in their wallet.

 

2) You really need to understand that people with HIV are people. Real human beings. Sexy as fuck, annoying as hell, exciting, boring, but real and full of all of the same emotions as you. Maybe then, HIV won't be as terrifying, and, you can stop looking at someone and seeing the virus.

 

PrEP is a good thing and has its purposes. You and I have messaged back and forth and we've talked a lot about it, but the fear is something you should figure out how to get passed.

 

 

 

didn't with another because I knew going in that he was HIV+ and couldn't relax enough to really trust that it would be safe with a condom

This is very unfair to him and to yourself. You have the knowledge and facts, from the CDC, from people with firsthand experience, etc... and still choose not to trust. That is very sad.

[escortrod]

1) Put a condom in your wallet and leave it there for those moments when things "occur" with spontaneity. You'll never again have to say, we can't have sex because we don't have a condom. Most men that I know, have one with them permanently in their wallet.

Just be sure to replace it regularly. A wallet is a pretty tough environment for a condom (body heat, lots of friction). The last guidance I read suggested that a month was the longest you should keep a condom there.

 

This is very unfair to him and to yourself. You have the knowledge and facts, from the CDC, from people with firsthand experience, etc... and still choose not to trust. That is very sad.

I know that it's incredibly unlikely that a commercial airliner is going to crash, but I'm still nervous on takeoff, landing and during turbulence. I don't think @youngboldone was making any more of a choice than that.

[+ BenjaminNicholas]

Put a condom in your wallet and leave it there for those moments when things "occur" with spontaneity. You'll never again have to say, we can't have sex because we don't have a condom. Most men that I know, have one with them permanently in their wallet

 

Actually, don't ever do that. Constant body heat and pressure of sitting on a wallet is as bad for a condom as using a petroleum-based lube.

 

Other advice here has been solid: Find a doc you can speak openly with, get on PrEP, find your comfort level from there on out. While there's no 100% risk-free way to have sex in this particular day and age, you can make sensible choices to limit problems. It sounds as if you're on the right track.

[KennF]

I know that it's incredibly unlikely that a commercial airliner is going to crash, but I'm still nervous on takeoff, landing and during turbulence. I don't think @youngboldone was making any more of a choice than that.

 

I respect your opinion, but respectfully disagree. In this case, I am saddened.

 

The OP isn't just "worrying". The chances of getting hit by a vehicle while walking on the sidewalk are pretty slim, as well. But, choosing not to go to a particular movie theatre when you really want to see the movie because you distrust that you won't get hit by a vehicle while walking on the sidewalk is more than simple 'worry'.

 

And, the stigmatism he puts on people based on their HIV status is unfair.

 

Sorry.

[escortrod]

I respect your opinion, but respectfully disagree. In this case, I am saddened.

 

The OP isn't just "worrying". The chances of getting hit by a vehicle while walking on the sidewalk are pretty slim, as well. But, choosing not to go to a particular movie theatre when you really want to see the movie because you distrust that you won't get hit by a vehicle while walking on the sidewalk is more than simple 'worry'.

 

And, the stigmatism he puts on people based on their HIV status is unfair.

 

Sorry.

I’m not sure that you are disagreeing with me. My point was that he is experiencing an irrational fear or phobia that cannot simply be overcome by reason. It is certainly unfair to the escort, and those with HIV, but I don’t know what you expect the OP to do if he is so deeply uncomfortable/phobic.

[+ Seaninsf]

I'd say talk to a (vs. your) doctor - one who you can feel comfortable being open about your situation, this may require finding a new/different doctor. I don't think the escorting detail is important to share, especially since that's illegal

 

Completely agree with @JEC's points about open communication. Everyone should be able to have open and frank communication with their physician. I would even go so far as to say including the fact that you like to entertain gentleman for hire is important. Your physician is your partner in ensuring your good health. That becomes very difficult when information is withheld or filtered. If you are not comfortable being honest and direct with your physician, or they do not create an environment where that is encouraged, then you need to find a new doctor. Lastly, discussions with a healthcare provider are protected by law (with exceptions for concerns about abuse). Anyone who violates that would be violating ethical and legal codes.

 

Take care of yourself, YBO, emotionally and physically.

[youngboldone]

KennF, if you have actual statistics and scientific evidence you'd like to share that will reassure me that having protected sex with an HIV+ person is no risk, I'm happy to receive that information with an open mind. Otherwise, please stop vilifying me. I am in no way stigmatizing those who are poz. In face, in spite of my fear, I went ahead with the appointment I scheduled with the escort. I even wrote him a glowing review afterward. I venture to guess not many others would have done that. So, what would you have rather I'd done to be more fair to the escort? Would canceling the appointment have been fair to him? Was I supposed to do anal with him just to show him I have no fear? Yes, I do have fear surrounding this issue, and that healthy fear has kept me alive and HIV free for 44 years. Please stop attacking someone who's just trying to find his way in a very scary world. You're not helping.

[KennF]

@youngboldone I am not vilifying you.

 

CDC site has been put up before and the topic has been well discussed.

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

https://www.cdc.gov/hiv/basics/prevention.html

 

Here are additional sites:

https://www.poz.com/article/condom-PrEP-efficacy-26766-8889

https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis

https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/20/48/the-basics-of-hiv-prevention

http://www.catie.ca/en/fact-sheets/prevention/condoms

https://www.nhs.uk/chq/Pages/3100.aspx?CategoryID=118

http://www.who.int/hiv/topics/condoms/en/

http://www.nejm.org/doi/full/10.1056/NEJMp068111#t=article

https://www.aidschicago.org/resources/legacy/condoms/ltoyw_fact.pdf

http://www.unaids.org/en/resources/presscentre/featurestories/2015/july/20150702_condoms_prevention

Within each are reference material down to the studies and published works that support each of the articles.

[+ oldNbusted]

They only thing I could claim as a PrEP side effect was usually vivid dreams. I dreamed about meeting my favorite working guy last night.

[youngboldone]

They only thing I could claim as a PrEP side effect was usually vivid dreams. I dreamed about meeting my favorite working guy last night.

 

That's the kind of side effect I could live with!

[big-n-tall]

One escort I was talking to about PrEP said he had to get off of it. He said his doctor told him there was evidence PrEP was damaging his liver. I don't know how common that symptom is.

[+ GregM]

One escort I was talking to about PrEP said he had to get off of it. He said his doctor told him there was evidence PrEP was damaging his liver. I don't know how common that symptom is.

 

That's one of the side effects. My Dr moved me to genvoya (sp) because it was less likely to cause liver damage. But I'm not fortunate enough to be on prep as the damage has already been done. It amazes me at 2018 the ignorance and fear still out there. But whatever's.

 

Hugs,

Greg

[youngboldone]

This may be taking the conversation in a tangential direction, but since the topic has been alluded to, it's gotten me thinking. I know that it's incumbent upon the client or really anyone going in to any sexual encounter to assume that your partner is HIV + and then act accordingly. However, it's one thing to assume someone else is poz and another thing entirely to know for a fact that they are before you consider engaging in sexual activity with them. So, what are the ethics involved on the escort side if the escort knows for a fact that they are poz? I would hope that, at the very least, they are advertising safe only and sticking to only safe sex with clients, and I feel they should also be disclosing this information to the client so that he can make an informed decision whether to meet. Part of me feels, however, (and I realize some on here are going to take offense to this but save your mean, vicious, retorts because this is my opinion and I don't care) escorts who know they are poz probably should not even be in this business. Granted, if you hook up with someone via Grindr, Scruff, Growlr, or in a bar, you don't know their status, but at least in those scenarios they aren't charging you money for an act that could potentially infect you with a fatal disease.

[SuenosAmor]

I'd definitely take a look at the resources that KennF posted.

[escortrod]

This may be taking the conversation in a tangential direction, but since the topic has been alluded to, it's gotten me thinking. I know that it's incumbent upon the client or really anyone going in to any sexual encounter to assume that your partner is HIV + and then act accordingly. However, it's one thing to assume someone else is poz and another thing entirely to know for a fact that they are before you consider engaging in sexual activity with them. So, what are the ethics involved on the escort side if the escort knows for a fact that they are poz? I would hope that, at the very least, they are advertising safe only and sticking to only safe sex with clients, and I feel they should also be disclosing this information to the client so that he can make an informed decision whether to meet. Part of me feels, however, (and I realize some on here are going to take offense to this but save your mean, vicious, retorts because this is my opinion and I don't care) escorts who know they are poz probably should not even be in this business. Granted, if you hook up with someone via Grindr, Scruff, Growlr, or in a bar, you don't know their status, but at least in those scenarios they aren't charging you money for an act that could potentially infect you with a fatal disease.

Wow. I wish I could retract the defence of you I mounted in this thread.

 

Did you read any of the articles that @KennF linked to? In terms of HIV transmission it’s safer to have sex with a poz person who is on meds and undetectable than with somebody who thinks they are negative (but could well be wrong). The guys who think they are negative “could potentially infect you with a fatal disease.” Moreover you seem to assume that all clients are HIV negative and/or care about the escort’s HIV status, if you think poz escorts should not be in the business. On both counts you are incorrect.

 

Please go and educate yourself instead of spreading such stigmatising nonsense.

Edited January 19, 2018 by escortrod