Category Archives: Hiv Issues

The Pill That Prevents HIV Is As Safe As Daily Aspirin

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Taking Truvada every day to prevent HIV isn’t any more dangerous than taking a daily aspirin to prevent heart attacks, a new study finds.

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Truvada

People who take Truvada, the once-a-day pill that prevents HIV, are no more at risk for dangerous side effects than those who take an aspirin a day to prevent heart attacks, according to a new study.

Researchers compared Truvada and aspirin by looking at the drugs’ risk profiles in large, published studies. Although the two drugs come with distinct side effects — Truvada most commonly causes dizziness, vomiting, and weight loss, whereas aspirin is most commonly associated with bleeding problems — the frequency of side effects is roughly equivalent.

But the drugs have very different reputations, among both doctors and the general public. Century-old aspirin, when taken as a preventative tool against heart attacks, is viewed as an everyday medication, no big deal. But Truvada, also known as pre-exposure prophylaxis (or PrEP), is a new pill, intertwined with the loaded issues of HIV and sex habits, and mired in uncertainty.

“Everyone’s got aspirin in their medicine cabinet,” Jeffrey Klausner, professor of medicine and public health at the University of California, Los Angeles, and lead author of the study, told BuzzFeed News. “But as a physician I’ve seen people come into the hospital and die from aspirin overdoses — people can be allergic.”

The side effects of each drug are markedly different, Klausner noted, and affect different organs. But after crunching the numbers, he said, “it really looked like I could say Truvada compared favorably, in terms of its safety profile, to aspirin.”

An estimated 52% of American adults aged 45 to 75 are prescribed a daily aspirin to prevent cardiovascular and gastrointestinal diseases, including heart attacks and cancer.

Truvada, which was approved by the FDA in 2012, has been shown to have roughly 92% efficacy in preventing transmission of HIV. The CDC estimates that about 1.2 million Americans are at high enough risk for contracting HIV that they should be prescribed the drug. But only about 21,000 currently get it.

According to Klausner, who trains doctors around the country on how to treat and prevent HIV, much of this has to do with ambivalence about prescribing otherwise healthy individuals a daily pill.

“A lot of the concerns I hear from providers are about safety,” Klausner said. “There have been continued voices saying, ‘Wouldn’t it just be better if people used condoms, or reduced their number of partners?’ Those are important strategies, but they don’t work for everyone.”

The issue of doctor awareness about PrEP is one of the biggest barriers to its wider use.

The new study “is an interesting thought experiment,” Dawn Smith of the CDC’s Division of HIV/AIDS Prevention, told BuzzFeed News. But, she added, “I’m not sure it addresses the safety concerns that some clinicians have.”

Smith noted a CDC study showing that in 2015, about one-third of primary care doctors and nurses had never heard of Truvada. Beyond the lack of awareness, she said, doctors don’t want to cause any side effects, no matter how minor, in otherwise healthy patients.

In his analysis, Klausner looked at the “NNH” — or “number needed to harm” — meaning the number of people who take the drug before one person experiences a harmful side effect. The NNH for Truvada in gay men or transgender women was 114 for nausea and 96 for unintentional weight loss. In women, side effects appeared more frequently, with 1 in 56 women experiencing nausea, 1 in 41 vomiting, and 1 in 36 mildly elevated liver enzymes.

Rarer adverse events for Truvada include kidney problems and a small decrease in bone mineral density, but Klausner notes that both of those effects have been shown to be reversible once the medication is discontinued.

In contrast, aspirin had an NNH of 15 for bleeding problems and 20 for easy bruising. Rarer problems included ulcers and other gastrointestinal problems.

Because it’s so much older, aspirin has been tested in many more people with many more years of follow-up, Klausner noted. Because Truvada is a relatively new drug, it will take awhile to accrue the data needed to make its long-term safety bulletproof.

In the meantime, however, Klausner hopes more doctors will educate themselves about the HIV prevention drug. And after that, he said, “we should work to make it the same price as aspirin.”

Complete Article HERE!

Survivors of 1980s AIDS crisis reveal what happened to them

In Honor of World AIDS Day

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From the role of lesbians to the vanishing of whole neighborhoods, real LGBTI people share their experiences

by Joe Morgan

Survivors of the 1980s AIDS crisis have shared accounts of their experiences.

As the UK celebrates LGBT History Month, users of Reddit revealed what it was like to be living in what felt like a constant state of tragedy.

Real LGBTI people remember the confusion, the lack of information, the lack of support from the government because of the suffering from the virus known only at the time as GRID (gay-related immune deficiency).

‘I’m a 62-year-old gay man. I thankfully made it through the epidemic that started in the early 80s and went right through the mid-90’s. You ask what it was like? I don’t know if I can even begin to tell you how many ways AIDS has affected my life, even though I never caught the virus,’ one user said.

‘By the early 80s, I had what I would consider a really large circle of friends and acquaintances and once the epidemic really started to hit, it was not uncommon to find out three, four or more people you knew had died each month. We set up informal and formal support groups to look after our friends who took sick. Feeding them when they would eat. Changing them. Washing them. Acting as go-between with families who “were concerned” about their sons, nephews, brothers, etc., but wouldn’t lend a hand to help because AIDS was, you know, icky.

‘After they passed, there were memorial services to plan with no real time to grieve because when one passed, you were needed somewhere else to begin the process all over again.

‘I kept a memory book/photo album of everyone I knew that died of AIDS. It’s quite large to say the least. Who were these guys? These were the people I had planned to grow old with. They were the family I had created and wanted to spend the rest of my life with as long as humanly possible but by the time I was in my late 40s, every one of them was gone except for two dear friends of mine.

‘All we have left of those days are each other, our memories and pictures. I hope that statement doesn’t come off as pitiful though. I am fit, active, healthy and you know what? I enjoy every single day of my life. I enjoy it because most of my friends can’t. In my own personal way, I want to honor their lives by living and enjoying mine.’

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Another user said: ‘It was flat out scary. every guy you met was like a possible time bomb. especially the early period when we knew very little about it – didn’t know if you could get it by kissing, by holding hands…

‘Then lots of your friends or friends of friends get sick and sicker and then die. And you never ever quit being really really fucking pissed off about the whole thing. I’m alive today due to sheer randomness.’

And another said: ‘If you were living in the Castro in San Francisco, everyone in the neighborhood was gay… So it wasn’t just your friends that were dying, it was your whole neighborhood. One day your mailman would be replaced, the next day that flower shop was gone… You wouldn’t be invited to the funeral, so it was just like people were disappearing.’

‘It was madness. It was terribly cruel,’ another Redditor said. ‘It was inexplicable and unexplained, for a very long time. Research was underfunded, and in many cases large institutions and public figures rooted for it to be happening. People died suddenly of unexplainable things. Toe fungus! Tongue thrush! Rashes. Eyes welling up with blood. Horrible shit.

‘Everyone knew it was hitting gay men, nobody knew what it was. They called it the gay cancer. People were very superstitious. I had handfuls of groceries and man lectured me on not pressing the elevator buttons with my nose because I could catch AIDS from it. Yes. That happened.’

A lesbian of the era said: ‘While I was not ‘at risk’ (per se, we know more these days), we all lost many good friends. It is true that there is a somewhat mystifying (to me) separatist attitude between some gay men and lesbians, especially back then, this tragic time really brought us together.

‘Sitting at the bedside of a terminally ill friend, and just holding their hand when everyone else was just terrified, was a gift I was one of those willing to give.

‘No one should die alone, and no one should be in the hospital on their death beds with family calling to say “this was gods punishment”. My friends and I, men and women, acted as a protective layer for ill friends, and companion to mutual friends juggling the same, difficult reality of trying to be there, and be strong when we were losing our family right and left. Difficult times, that should never be forgotten.’

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Another Redditor paid tribute to the role of lesbians, calling them ‘every bit as heroic as soldiers on the front lines of any war’.

‘These women walked directly into the fire and through it, and they did not have to. And that they did it even as some of the gay men they took care of treated them with bitchiness, scorn, and contempt.

‘It was, at the time, not at all unusual for gay men to snicker as the bull dyke walked into the bar with her overalls and flannels and fades. Much of the time, it was casual ribbing which they took in stride. But it could also be laced with acid, especially when lesbians began gravitating toward a bar that had until then catered largely to men.

‘When the AIDS crisis struck, it would be many of these same women who would go straight from their jobs during the day to acting as caregivers at night. Because most of them lacked medical degrees, they were generally relegated to the most unpleasant tasks: wiping up puke and shit, cleaning up houses and apartments neglected for weeks and months. But not being directly responsible for medical care also made them the most convenient targets for the devastating anger and rage these men felt – many who’d been abandoned by their own family and friends.

‘These women walked directly into the fire. They came to the aid of gay men even when it was unclear how easily the virus could be transmitted. Transmission via needlestick was still a concern, so they often wore two or three layers of latex gloves to protect themselves, but more than once I saw them, in their haste and frustration, dispense with the gloves so that they could check for fevers, or hold a hand that hung listlessly from the edge of a bed whose sheets they had just laundered.

‘They provided aid, comfort, and medical care to men withering away in hospices, men who’d already lost their lovers and friends to the disease and spent their last months in agony. They’d been abandoned by their own families, and were it not for lesbians – many if not most of them volunteers – they would have suffered alone. And when there was nothing more medicine could do for them and their lungs began to fill with fluid, it was often these same women who’d be left to administer enough morphine to release them, given to them by the doctor who had left the room and would return 15 minutes later to sign the certificate (a common practice at the time).

‘I knew a woman around that time who’d had at one point been making bank in construction. But at the outset of the AIDS crisis she had abandoned her career to pursue nursing instead, and was close to her degree when we were hanging out. She was a big, hearty drinker, and fortunately so was I. We’d been utterly thrashed at a bar once when someone whispered a fairly benign but nonetheless unwelcoming comment about her. Middle fingers were exchanged, and afterwards, furious and indignant, I asked her, Why do you do it? Why did you abandon a career to take care of these assholes who still won’t pay you any respect?

‘She cut me a surprisingly severe look, held it and said, “Honey, because no one else is going to do it.” I remember feeling ashamed after that, because my fury and indignation weren’t going to clean blood and puke off the floor; it wasn’t going to do the shit that needed to get done.

‘HIV killed my friends, took my lover from me, and tore up my life. During that time, I did what I could. But nothing I did then or have ever been called to do in my life puts me anywhere near the example set by the lesbians I knew in the 80s and 90s. I’ve felt obligated to remember what they did, and to make sure other people remember it too.’

Complete Article HERE!

2.5 Years Later, Zero Cases Of HIV In Large San Francisco PrEP Group

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A new study reveals that after 2.5 years, a group of more than 600 San Francisco men who have sex with men (MSM) taking Truvada as pre-exposure prophylaxis (PrEP) have had zero cases of HIV contraction.

The study also finds that many of these individuals are using condoms less and more than half of those in the group study had contracted at least one sexually transmitted infection (STI) within a year.

From POZ.com:

Researchers at Kaiser Permanente published their findings in Clinical Infectious Diseases. The paper represents a powerful endorsement of PrEP’s ability, in a real-world setting, to prevent HIV infection among those at very high risk of contracting the virus. The lack of new HIV infections among these men challenges the stance of AIDS Healthcare Foundation president Michael Weinstein, who has vigorously campaigned that PrEPshould not be used as a widescale public health intervention.

On the flip side, the Kaiser findings challenge the received wisdom from PrEP clinical trials that those taking Truvada as HIV prevention do not increase sexual risk-taking while on the medication.

“Our study is the first to extend the understanding of the use of PrEP in a real-world setting and suggests that the treatment may prevent new HIV infections even in a high-risk setting,” reports lead author Jonathan Volk, MD, MPH, a physician and epidemiologist at Kaiser Permanente San Francisco Medical Center. “Until now, evidence supporting the efficacy of PrEP to prevent HIV infection had come from clinical trials and a demonstration project.”

It’s important to reiterate that according to Kaiser, though no one using PrEP contracted HIV, there was a very high rate of other sexually transmitted infections (STIs).

POZ.com breaks it down:

After six months, the clinicians at Kaiser surveyed 143 of the cohort about their sexual risk-taking. At that time, 74 percent reported that their number of recent sexual partners had not changed since starting PrEP, while 15 percent said they had fewer sexual partners and 11 percent said they had more. Regarding condom use, 56 percent said they used them at the same rate after starting Truvada, 41 percent used them less and 3 percent used them more.

Because these individuals were not engaged in a clinical trial, there is no control group to measure the change in these men’s sexual risk-taking against. So there is no way to tell if the group would have changed their risk-taking in a similar pattern if they had not been taking PrEP.

One thing is clear, however: These men would have been at very high risk of contracting HIV had they not been taking PrEP while engaging in the same level of sexual risk-taking. The evidence is in their very high rate of STIs. Six months into taking PrEP, 30 percent of the PrEP users had been diagnosed with at least one STI. After a year, half of them had contracted one or more STIs, with 33 percent diagnosed with a rectal STI, 33 percent with chlamydia, 28 percent with gonorrhea, and 5.5 percent with syphilis. As noted, two of them contracted hep C.

“Without a control group, we don’t know if these STI rates were higher than what we would have seen without PrEP,” stressed the paper’s co-author Julia Marcus, PhD, MPH, postdoctoral fellow at the Kaiser Permanente Division of Research. “Ongoing screening and treatments for STIs, including hepatitis C, are an essential component of a PrEP treatment program.”

No one in the group has been diagnosed with HIV.

Our takeaway, PrEP is clearly doing its job in HIV prevention, however we need to remain vigilant in testing and treatment for STIs. The choice to use or not use condoms is up to the individual, but be aware of the risks and ensure that you’re regularly being tested to protect your health and potentially that of your sexual partners.
Complete Article HERE!

Mellow With Age

Name: Bob
Gender: Male
Age: 54
Location: Laguna Beach
As an older man, I’ve started having performance problems. Unfortunately there’s no decrease in my libido. I think some of my problem is psychological. I’m also HIV+. And I find myself worrying about transmission even with condoms. But some of the problem is physical. I do wear a cockring and that helps I guess. Is there anything else I can do to increase my performance to match my libido?

Thanks for your comment and question. Your concern is a familiar one. Men regularly present this problem in my private practice and I also have a personal familiarity with the issue in my own life.

Diminished performance, at least in terms of a perpetually stiff dick, is a natural occurrence as we age. There was a time when I thought this was a major problem. I don’t think like that now. These days I’m helping my older clients (and myself) appreciate the full range of sensuality that is the unique purview of us more seasoned lovers. I’ve always felt that as gay men we are too genitally focused, especially when it comes at the expense of all the other pleasure zones our bodies have been gifted with.Kedori - Eileen Gray Bibendum Armchair

The rushed, hormonally driven sex of my youth has matured into a slower, more relaxed and sensual sexuality that I am thoroughly enjoying. This has been one of the very best gifts of the aging process. It’s even having an effect on my younger partners and they are appreciative.

So I no longer equate performance with a stiff dick. For those times when I absolutely need a rock-hard hardon a cock ring does just fine. I’m aware that I may need more time to achieve this kind of erection, but I’m not just twiddling my thumbs while I’m waiting, if ya know what I mean. I am no longer frustrated by this natural phenomenon, because I no longer have unrealistic expectations.

I realize that many men are using with an erection-enhancing medication such as Viagra, but I suggest that this be reserved for those who are truly experiencing erection dysfunction.

I’m also concerned with the alarming rise of younger men, men in their 20’s and 30’s who are using Viagra or another similar drugs recreationally. This is very troubling. If your young body is having difficulty producing an erection, then you need medical attention ASAP, or maybe you just need some sleep. However, if you’re abusing Viagra just so you can have an erection that lasts for hours that’s a real bad idea for several reasons. Not least of which is your body will habituate itself to that stuff and you will find that, in time, you won’t be able to get it up at all without ever increasing doses of Viagra.

viagra cartoonThis is gonna fuck up your cardiovascular system big time. In fact, you may very well be inducing the very sexual dysfunction the drug is supposed to help. Consider the person who overuses eye drops or lip balm or any number of otherwise innocuous health and beauty products. Their body will stop making the natural substances that these over the counter products are intended to assist. It’s counterproductive and it’s ill advised. If this is a problem with relatively harmless over the counter products, you know you are playing with fire when you’re abusing powerful prescription meds.

Whoops, sorry Bob, I went off topic there for a minute. It’s just that every opportunity I get to put out a message that will dissuade someone from hurting one’s self, I just launch into it.

So back to you. It is clear from what you tell me, your performance problems do, as you suggest, also have a psychological component to it. You have a fear that, despite being responsible in your sex play and even though you play safe, you could accidentally pass on HIV.

It’s true; one’s brain can indeed override almost every function of our body. For example, we draw each and every breath we take without even thinking about it. However, if a situation dictates our brain can and does override that essential pulmonary function and we can hold our breath. The same is true with our sexual response cycle. Sometimes we can become sexually aroused without really thinking about it. However, if for one reason or another our brain assisted by our conscience interferes with or even shuts down the sexual arousal, that’s pretty much, all she wrote.

Your scruples about the possibility that you could accidentally pass along HIV are interfering with your sexual response cycle. No cockring or an erection-enhancing medication is going to change that darlin’!

In other words, the problem is not in your cock, the problem is in your head. This is something you’re gonna have to wrestle with and finally resolve. This tension between your head and your dick is actually a good thing. Your body is providing you an opportunity to align your moral values with your sexual performance. How will this resolve itself? I couldn’t say. But I know for sure resolution is possible.

I do suggest, however, that you not try to do this in a vacuum. Reach out to a HIV support group or a sex-positive therapist for the help you need in making peace between your head and your cock.

Good luck

Batter Up

Name: Trey
Gender: Male
Age: 17
Location:
I’m 17 years old. I hit puberty at age 10, so I have had time for my dick to grow, but it hasn’t. I’m 1 inch soft and 4 inches hard. Why? Is it normal? I mean all the other guys have dicks at least 4 inches soft and like 6-8 inches hard. Even one of my of my 13-year-old friends dick is honestly 6 inches soft! What is wrong with me? Why is mine so small? Is it abnormal for my age? I have heard that weight can have something to do with it? I’m about 240 pounds. Can you help? I can’t do surgeries or enhancement pills or whatever. I mean, give some names of medicines and I can talk to my doctor or something.

Normally I wouldn’t respond to yet another question about how one grows his dick bigger. I’ve already dedicated enough ink to this topic to last a lifetime. If you want the 411 on cock enlargement techniques of all types, all you have to do is use the search function in the header and search for topics like: cock size, cock shape and jelqing. Or look for these topics in the CATEGORY pull down menu in the sidebar. You’ll find everything I have to say on the subject.  Here’s an example of what I am talking about — Much Ado About Very Little.

But for your benefit, Trey, I’ll summarize. Our dick size is determined by genetics, like our skin color, hair color, stature and the like. Permanent male enhancement by any means, short of surgery, is a fiction. And surgery is an exceptionally risky procedure, often times only making matters worse.

The only reason I decided to publicly respond to your question, Trey, is because you mention your weight. You tell me you are 17 years old and you weigh about 240lbs. That’s astounding, pup. Unless you are 7” tall and built like a brick shithouse, you must be considerably overweight, perhaps even obese. If I were you, darlin’, I’d consider my weight problem to be a much bigger liability then the size of my baloney pony.

Seriously, one sure fire way to add to your dick size is to lose weight. Think about it, if your unit is struggling to peek out from under a big fold of fat hanging down from just above your cock, you could easily add a couple inches if you trimmed the fat. But dick size aside, you’re simply carrying too much weight and at such a tender age. YIKES!

You know you are at risk for diabetes, circulatory problems and cardiac problems, right? Each and every one of these will impact in a very negative way on your sexual response cycle. So even if you could magically grow you dick bigger, your weight will defeat you; making it impossible for you to get it up and get it off.

I encourage you to seriously consider a lifestyle change, pup. Do it so you’ll have a bigger dick, if that’s what you really want. And in the process you’ll also insure a healthier heart making that bigger dick of yours function like it oughta.

Good luck

Name: razor
Gender: Male
Age: 34
Location: Texas
My partner and I have been together for about 8 months now. I can’t even say we had a great, awesome, sex life at first. There was something else. I thought I had found a good person and friend in him. He is very sexy, lean and hung. Honestly, I should really want him. I’m poz, and he’s not. I, wonder if that could be the reason, why I don’t desire him? Afraid that I might hurt him somehow. Or could this be just what I think it is, could I just not want sex?

Mmmm, I’d go with the first option, if I had to pick one. I’d be willing to guess that the disparity between you and your BF’s HIV status is indeed getting in the way of your eroticism. And that’s a big fat bummer, because it doesn’t have to be like that.

Correct me if I’m wrong, but the lack of desire for this hot and hunky HIV- guy isn’t getting in the way of you guys having a good relationship, is it? The reason I ask is that many happy secure relationships are based on other things besides sex. You say he’s a good person and a friend. Maybe that’s all you need to make this relationship work and last. Most long-term relationships wind up being relatively sexless anyway. Instead of sexual fulfillment, the couple finds contentment in the intimacy and stability of the relationship. And that is often more gratifying than a vigorous roll in the hay.

As to your fears about possibly hurting your guy through sex…well life is full of risks, right? Your man is equally aware of the possibility of an accidental sero-conversion as you, right? But he stays with you. Why is that? Maybe he’s willing to take the risk; because he has this other connection with you…ya know the friendship thing. Maybe he is confident about the safe sex he practices. Maybe sex is not all that important to him, considering he’s in a relationship with a good man who is his friend. Maybe you just oughta ask him.

At the same time, there’s loads of very pleasurable sexual activities you guys could involve yourselves in which carry very little to absolutely no risk of an HIV accident. Maybe you just need to get a little more creative in your sex play. Lots of mixed HIV couples have figured this out already.

Fear is an ugly thing, Razor. It can, as you suggest, shut down a person’s entire erotic life. But I encourage you not to let this happen to you. Push past your fears. Work with a sex-positive therapist or an HIV support group, if you must. Just don’t settle for the status quo. Even if your current relationship isn’t dependent on a regular slap and tickle, you oughtn’t live your life like you are some kind of Typhoid Mary. That is if you ask me.

Good luck

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