Search Results: Pes

You are browsing the search results for PES

Trust a Scientist: Sex Addiction Is a Myth

FacebookTwitterGoogle+PinterestTumblrShare

By Jim Pfaus

A psychologist explains why sex addiction therapy is more about faith than facts, as told to Tierney Finster

001

Self-labeled sex addicts often speak about their identities very clinically, as if they’re paralyzed by a scientific condition that functions the same way as drug and alcohol addiction. But sex and porn “addiction” are NOT the same as alcoholism or a cocaine habit. In fact, hypersexuality and porn obsessions are not addictions at all. They’re not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and by definition, they don’t constitute what most researchers understand to be addiction.

Here’s why: addicts withdraw. When you lock a dope fiend in a room without any dope, the lack of drugs will cause an immediate physiological response — some of which is visible, some of which we can only track from within the body. During withdrawal, the brains of addicts create junctions between nerve cells containing the neurotransmitter GABA. This process more or less inhibits the brain systems usually excited by drug-related cues — something we never see in the brains of so-called sex and porn addicts.

A sex addict without sex is much more like a teenager without their smartphone. Imagine a kid playing Angry Birds. He seems obsessed, but once the game is off and it’s time for dinner, he unplugs. He might wish he was still playing, but he doesn’t get the shakes at the dinner table. There’s nothing going on in his brain that creates an uncontrollable imbalance.

The same goes for a guy obsessed with watching porn. He might prefer to endlessly watch porn, but when he’s unable to, no withdrawal indicative of addiction occurs. He’ll never be physically addicted. He’ll just be horny, which for many of us, is merely a sign we’re alive.

There haven’t been any studies that speak to this directly. As such, the anti-fapper narrative is usually the only point discussed: Guys stop masturbating after they stop downloading porn, and after a few days, they say they’re able to get normal erections again. This coincides with the somewhat popular idea that watching porn leads to erectile dysfunction, a position that porn-addiction advocates such as Marnia Robinson and Gary Wilson state emphatically. (Robinson wrote a book on the subject, though her degree is in law, not science, and Wilson, a retired physiology teacher, presented a TED Talk about hyperstimulation in Glasgow.) These types of advocates are wedded to the idea that porn is an uncontrolled stimulus the brain gets addicted to because of the dopamine release it causes. According to their thinking, anything that causes dopamine release is addictive.

But there’s a difference between compulsion and addiction. Addiction can’t be stopped without major consequence, including new brain activity. Compulsive behavior can be stopped; it’s just difficult to do so. In other words, being “out of control” isn’t a universal symptom of addiction.

002

Then what, exactly, does it mean when Tiger Woods and Josh Duggar go to rehab for sex addiction? Or when Dr. Drew offers it up on TV for washed-up celebrities? The answer is simple: They’re giving free marketing to the new American industry of sex addiction therapy. Reformers Unanimous, the faith-based treatment program chosen by Duggar, is likely to gain a number of new patients thanks to the media frenzy surrounding his admission to their facilities after the Ashley Madison hack exposed the affairs Duggar blamed on porn addiction.

These programs are similar to traditional 12-step models, except even more informed by faith. By misdiagnosing patients from the start, they gloss over the underlying issues that might make someone more prone to compulsive sexual behaviors, including Obsessive Compulsive Disorder and depression. Plenty of compulsive and ritualistic sexual behaviors aren’t addictions; they’re symptomatic of other issues.

Unfortunately, that’s just scratching the surface of the faulty science practiced by these recovery centers. For instance, according to proponents of the sex addiction industry, the more porn someone watches, the more they’ll experience erectile dysfunction. However, my recent study with Nicole Prause, a psychophysiologist and neuroscientist at UCLA, showed that’s absurd. While advocates of sex and porn addiction are quick to correlate the amount of porn a guy looks at to how desensitized his penis is, our study showed that watching immense amounts of porn made men more sensitive to less explicit stimuli. Simply put, men who regularly watched porn at home were more aroused while watching porn in the lab than the men in the control group. They were able to get erections quicker and had no trouble maintaining them, even when the porn being watched was “vanilla” (i.e., free of hardcore sex acts like bondage).

There is, of course, other evidence that porn isn’t a slippery slope to physical or mental dysfunction. A paper just came out in the Journal of Sex & Marital Therapy from German researchers that looked at both the amount of porn consumed by German and Polish men and women and their sexual attitudes and behaviors. It found that more porn watched meant more variety of sexual activity — for both sexes.

Despite these results, there’s still an entire publication, Sex Addiction & Compulsivity, committed to demonstrating that porn creates erectile dysfunction. Its very existence suggests sex addiction and its treatments are real, yet the journal doesn’t take a stance on any particular treatments. And while its resolutions come from peer-reviewed articles, these articles only get reviewed by people who already believe in the notion of sex addiction.

003

Which is why the journal has zero impact. The number of times a scientific journal gets used in other scholarly work is measured by something called the Journal Citation Reports (JCR). That number determines a journal’s official impact factor. So far, Sex Addiction & Compulsivity has a JCR impact factor of 0.00. Nobody cites anything from it, except maybe their own cult of followers who publish on blogs and personal websites.

The journal benefits from a very 21st century way of creating a veneer of objectivity. As long as there are papers in it, people can cite them as “scientific.” Even if the work — and the people who oversee it — are anything but. An influential associate editor there is David Delmonico, a professor who runs an “internet behavior consulting company” that offers “intervention for problematic Internet behaviors.” He believes sex addiction is real because he’s wary of the supposedly horrible effects the internet (and all the porn there) can have on human behavior.

Such porn-shaming isn’t all that different from the guilt conservatives attach to sex, even though conditioning men to feel bad about their sexual behaviors only leads to the kind of secretive, damaging behaviors evidenced in the Duggar story. What’s worse: when sexuality is labeled a “disease” like addiction, guys no longer have to own their sexuality — or their actions. It’s unnecessary to explain why they cheated because it’s beyond their control. And so, the “addict” stigma is preferable because it’s one they can check into rehab and recover from. Being considered an “adulterer,” on the other hand, is harder to shake.

Complete Article HERE!

Gags & Nipple Clamps 101

Lookin’ to spice up your Valentine? When roses and chocolates just ain’t gonna cut it…

Nipple clamps

Gripper Nipple Suckers by Atomic Jock

Gripper Nipple Suckers by Atomic Jock

First up are the infamous nipple clips or clamps. They are a favorite in sensation play. Whether it’s sucking, pinching, prodding, or pulling the nipples, clamps are meant to flirt with the painful side of pleasure. Don’t let the discomfort angle scare you off . Nipple clips can be perfectly harmless, especially for beginners, when used correctly.

Also, remember, both genders have nipples, so this needn’t be for women only. When picking out a tit torture product, you can test the strength on your finger or even better, the flesh of your arm, which is fairly sensitive. A good rule of thumb is that if it hurts your finger, your nipple is not going to be happy. Definitely work up to a stronger clamp if that’s your goal.

3-Speed Vibrating Nipple Clamps

3-Speed Vibrating Nipple Clamps

For beginners, I suggest a sucking type of clamp like Gripper Nipple Suckers by Atomic Jock to stimulate your nipples to full attention. They are easy to use (simply squeeze and let go on the nipple). If you are up for something a bit more edgy, try the 3-Speed Vibrating Nipple Clamps.

They vibrate wirelessly (which can help intensify the pressure in a good way), are waterproof, and, best of all, fully adjustable for whichever kind of level you are at. Pairing some trusty nipple clamps with restraints (and heck, throw in a blindfold!) will work superbly as torture play. Tease, tease, and tease your partner some more with the exquisite pressure of nipple clamps. They will definitely bring out your naughtier side.

Blind folds

Institutional Fleece Lined Blindfold

Institutional Fleece Lined Blindfold

Next, is the realm of sensory deprivation.

It may sound like an insignificant and simple item, but a blindfold can make a world of difference. Covering your or your lover’s eyes creates a vulnerability that can be quite thrilling.

If you don’t know when or where the next caress, pat, or lick will go you can be sure that this will create a whole new level of sensual tension. Plus, with a good quality blind fold impeding your sight, other sensations will take charge with a vengeance.

Try covering your lovers eyes while whispering something suggestive into his/her ear. Or, even better, both strip to the buff, make sure the blind is secure, and surprise them by ravishing different parts of their body, or rubbing parts of yours all over them. Especially paired with your favorite restraint, blindfolds can be a surprisingly new way to spice up your sex life.

Most any cloth material will work as a makeshift blindfold, but I suggest something like the Institutional Fleece Lined Blindfold as a starter product. It’s soft, dark, and molds to your face making each wear comfy with all the sexy benefits of sensory deprivation.

Restraints

Cotton Bondage RopeRestraints also heighten sexual tension. Whether it’s the cool metal of handcuffs (please, make sure you have the key!), the flexibility of rope, or the simplicity of scarves and ties, whatever you use to restrain your lover will provide a whole new dimension to sex play.

But first things first, some safety tips.

Have an exit: Make sure you both are comfortable with untying the knot or unlocking the cuff. Have a pair of scissors near to hand just in case.

Too tight is not right: This is a biggie: watch how tightly you knot the material or cuff. Cutting off circulation will get unsexy in a hurry. So if you or your partner feels any numbness, pain, or strain in their tied limb, speak up so the restraint can be adjusted. Having a mutual safe word as well as trying a few practice knots on yourself so you can be up to par and ready for the real session.

Once you’re a-OK with ropes, cuffs, or whatever you’re using, get ready to tease your partner KinkLab BedSpread Under Bed Bondage Strapsuntil they beg for more! For beginners, I would suggest using either Cotton Bondage Rope or the KinkLab BedSpread Under Bed Bondage Straps. Both are very user friendly (the bed bindings doesn’t even need a post or headboard!) and will ease you into your bondage fantasies.

Once you or your partner is successfully restrained, tease your way up and down their body, varying the pressure and consistency of your touch, pats or (even better) licks. Incorporate other sensations  (cold or hot, silky or rough, etc.) or other toys. Even your most steadfast vibrator can turn into a whole new experience once you’re no longer in control.

Gags

Tantus Beginner Ball GagThough there is very real potential for drool with this torture device, I say go for it! You will also be depriving your partner of speech. When they can’t tell you what they want, you must rely on moans, groans, and body language. The gag can be a major prop in role playing too.

Try some rougher play, with restraints and even a blindfold. The gag is meant to be power play, so maybe a game of sex slave for the afternoon with your lover on hands and knees with the ball gag and nothing else. Or the classic break-in situation, with a burglar restraining and gagging the unsuspecting victim before ravaging their body. It’s completely up to you.

As for products, try the Silicone Ball Gag w/ Garment Leather Strap to see if you like the feel. Those looking for more might consider stepping up to the Tantus Beginner Ball Gag. Just make sure you maintain proper hygiene in safely washing these toys, since they are going in your mouth. Many are silicone, rubber, latex, or metal, so easily washable, or even bleachable.Silicone Ball Gag w: Garment Leather Strap

Simply insert the gag into your/your partner’s mouth, adjust the strap, and there you go. Some more complicated gags have different parts, metal bits, or can be adjusted in multiple fashions. Also, since a safe word will be harder understand, be sensitive to each others body language, as it will indicate what they’re feeling. Overall, make sure you’re comfortable with the gag and then unleash your wilder fantasies.

My final tip is to keep your experimentation playful. Have a sense of humor about the whole blasted thing. If this play becomes a chore or a bore, shut it down and go back to your former alleged life.

Good luck

How Do I Get Laid?

Name: Thomas
Gender: male
Age: 18
Location: Dublin
I just want to know how you start and ask a girl to have sex.

Well, that sure is to the point, Thomas! I suppose the answer to that query will depend on the young woman in question. Do you have a particular girl in mind? Or is this a generic “how to” question?

first-love-quotes-hd-wallpaper-4

I’m of the mind that the direct approach works best, just so long as you’re not gonna be a dick about it. That being said, if the chick is a mate of yours and you fancy her, you’ll need to take a different approach to finessing a fuck than if you want to shag a relative stranger.

So, before I go much further with my advice on how to bag a bird, I think we’d better take a good look at you first.

Is there anything about you that would make you attractive to a young lass? I mean if you’re not overly geeky and have a bit of charm about you, your task is gonna be considerably easier than if you are some uncouth Neanderthal who just wants to dip his wick in some fine pussy.

If you’re not sure what kind of guy you are, ask a woman friend for her honest feedback. If she tells you she’d bump you in a pinch — you may have something going for you. If she tells you that she’d rather let her pussy die a slow lonely death than fuck the likes of you — you definitely have your work cut out for you.

First-Love-1Regardless of what group you fall into — the “possibly fuckable”, or the “not fucking ever;” you can always improve your image among the ladies. Look to how you present yourself; make sure you are groomed, clean and odor-free. Dress to impress. That doesn’t mean fancy or fussy. Just make it look like you gave your cloths a thought before you dressed yourself. Make yourself interesting; have a point of view. But share it sparingly. If you can’t be clever and witty, then keep your mouth shut for the most part. Women love the strong silent type. And they rarely know if the silence is stoic or stupid till it’s way too late.

And if you really want to get laid never approach any woman like she’s a piece of meat. If you think women are put on this earth simply to satisfy a man’s needs, stick to pullin’ your own pud. And here’s another tip: I always suggest that a guy squeeze one off before he goes on a date. This will take the edge off his sexual tension and his blue balls won’t be so friggin obvious to the lass he’s tryin’ to woo. There’s nothing more unattractive to most women than a desperate fuck. Besides, if you don’t jerk off first, you’ll have way too short a fuse and you’ll be finished before she even begins. Get it? Got it? Good!

If you’re not already friends with the chick you lookin’ to bone, take the time to become her friend. This will involve some effort. If you’re not in it for the long haul, then skip it and find yourself a pro who will get you off for a few quid.

If the woman you have in mind is already a friend, and she trusts you because you’ve been nice to her, you’re half way there. She’ll be more inclined to say yes to your direct request.

Keep in mind that women are different from men, especially where sex is concerned. Few women are as casual about sex as are most men. So if she says no don’t take it personally. She may just be shy, or not ready, or not sure. It’s your job to draw her out. Don’t pester and be patient while you do so. And most of all reassure her that you have her best interest at heart.

If she is uncomfortable with you, ask her why. You may learn some very interesting things about yourself that you need to work on. Maybe she just wants you to take your time and finesse her into giving up the bump.

If she has her wits about her, she’ll be concerned about the whole pregnancy thing. This is much more serious concern for a gal then for a guy. If you’re not well versed on several methods of contraception, you’re not ready to have sex. Sexually transmitted infections ought to be a concern for you both. Don’t be a fuck-up; always use a condom.

first-love

If you’ve got a hardon, it’s not the right time to be annoying a chick for sex. Talk about having sex other time when the need is not so urgent. If you pressure her to service your wood, you’re going about this at the wrong time and in the wrong way. If she senses that all you want is to satisfy your loathsome self, she’ll have you pegged as the asshole you are.

Remember that there are lots of different ways to have sex, so she might welcome one type while rejecting another. Maybe she’d be up for a hand job or blowjob, just no full-on fucking. Whatever the case may be, you’d be well advised to get her off a couple of times before you look to your own satisfaction. Whatever you do, respect her boundaries and let her know that you won’t pressure her to do anything she doesn’t want to do.

In the end, there no standard way to ask for sex, but if you treat the woman with respect, honesty, and patience, you can be sure that whatever words you use they’ll be more welcomed than if you’re a jerk.

Good luck

BDSM Versus the DSM

A history of the fight that got kink de-classified as mental illness

A history of the fight that got kink de-classified as mental illness

By Merissa Nathan Gerson

Asking your partner to tie you to the bedpost, telling them to slap you hard in the throes of lovemaking, dressing like a woman if you are a man, admitting a fetish for feet: Just a few years ago, any of these acts could be used against you in family court.

This was the case until 2010, when the American Psychiatric Association announced that it would be changing the diagnostic codes for BDSM, fetishism, and transvestic fetishism (a variant of cross-dressing) in the next edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 2013. The new definitions marked a distinction between behavior—for example, playing rough—and actual pathology. Consenting adults were no longer deemed mentally ill for choosing sexual behavior outside the mainstream.

The change was the result of a massive effort from the National Coalition for Sexual Freedom (NCSF), an advocacy group founded in 1997 “to advance the rights of and advocate for consenting adults in the BDSM-Leather-Fetish, Swing, and Polyamory Communities.” At the time, these types of sexual behavior, by virtue of their inclusion in the DSM, were considered markers of mental illness—and, as a result, were heavily stigmatized, often with legal repercussions. In family court, an interest in BDSM was used as justification to remove people’s children from their custody.

“We were seeing the DSM used as a weapon,” says Race Bannon, an NCSF Board Member and the creator of Kink-Aware Professionals, a roster of safe and non-judgmental healthcare professionals for the BDSM and kink community. (The list is now maintained by the NCSF.) “Fifty Shades [of Grey] had not come along,” says Bannon, an early activist in the campaign to change the DSM. “[Kink] was still this dark and secret thing people did.”

Since its first edition was published in 1952, the DSM has often posed a problem for anyone whose sexual preferences fell outside the mainstream. Homosexuality, for example, was considered a mental illness—a “sociopathic personality disturbance”—until the APA changed the language in 1973. More broadly, the DSM section on paraphilias (a blanket term for any kind of unusual sexual interest), then termed “sexual deviations,” attempted to codify all sexual preferences considered harmful to the self or others—a line that, as one can imagine, is tricky in the BDSM community.

The effort to de-classify kink as a psychiatric disorder began in 1980s Los Angeles with Bannon and his then-partner, Guy Baldwin, a therapist who worked mostly with the gay and alternative sexualities communities. Bannon, a self-described “community organizer, activist, writer, and advocate” moved to Los Angeles in 1980 and soon became close with Baldwin through their mutual involvement as open participants in and advocates for the kink community. “I’m fairly confident that I was the first licensed mental-health practitioner anywhere who was out about being a practicing sadomasochist,” Baldwin says.

002

The pair was spurred to action after the 1987 edition of the DSM-III-R, which introduced the concept of paraphilias, changed the classifications for BDSM and kink from “sexual deviation” to actual disorders defined by two diagnostic criteria. To be considered a mental illness, the first qualification was: ‘‘Over a period of at least six months, recurrent, intense sexual urges and sexually arousing fantasies involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer.’’ The second: ‘‘The person has acted on these urges, or is markedly distressed by them.’’

“1987 was a bad shift,” Wright recalls. “Anyone who was [voluntarily] humiliated, beaten, bound, or any other alternate sexual expression was considered mentally ill.”

With the new language, Baldwin says, he quickly realized that laws regarding alternative sexual behavior would continue to be problematic “as long as the psychiatric community defines these behaviors as pathological.”

“I knew there were therapists around the world diagnosing practicing consensual sadomasochists with mental illness,” he says.

At the time that the new DSM was published, Baldwin and Bannon were planning to attend the 1987 march on Washington, D.C., in support of gay rights; after the new criteria came out, they decided to host a panel discussion for mental-health professionals in the State Department auditorium, where they announced the launch of what would come to be known as “The DSM Revision Project.”

“We asked how many people in the room were mental-health professionals,” Baldwin says, and “two-thirds of the people in the room raised their hands. And we said, ‘The way this needs to happen is, licensed mental-health practitioners need to write the DSM committee that reviews the language of the DSM concerned with paraphilias.’”

Around 40 or 50 people left the session with the information needed to write the letters. “We did not know exactly what would result,” Bannon recalls. “We did not think we would see dramatic changes suddenly.”

They didn’t—but the changes they did see were positive. The next edition of the DSM, published in 1994, added that to be considered part of a mental illness, “fantasies, sexual urges, or behaviors” must “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

“This was a definite improvement from the DSM-III-R,” says Wright, who later took over leadership of the DSM Revision Project from Bannon and Baldwin.

“These criteria gave [health professionals] wiggle room to say, ‘They have issues, but it is not about their kink. For the vast majority, it is just the way they have sex,’” Bannon explains. “Rather than saying, ‘Because you are into this method of sexuality, you are sick,’ [they could say], ‘Pathologically, if this impacts your life negatively, then you have a problem.’”

But the new language in the 1994 DSM also allowed for wiggle room of a different kind: The threshold of “significant distress” was often loosely interpreted, with the social stigma of kink, rather than kink itself, causing the negative impact on people’s lives. Workplace discrimination and violence were on the rise, according to a 2008 NCSF survey, and people were still being declared unfit parents as a result of their sexual preferences: Eighty of the 100 people who turned to the NCSF for legal assistance in custody battles from 1997-2010 lost their cases.

A few years after the 1994 DSM was published, Wright decided it was time to fight for another revision. When she founded the organization in 1997, the NCSF’s goal was a change to the APA’s diagnostic codes that separated the behavior (e.g., “he likes to restrict his breathing during sex”) from the diagnosis (e.g., “his desire to restrict his breath means that he must be mentally ill”). The next DSM, the group argued, should split the paraphilias from the paraphilic disorders, so that simply enjoying consensual BDSM would not be considered indicative of an illness.

Their efforts were largely ignored by the APA until early 2009, when Wright attended a panel discussion at New York City’s Philosophy Center on why people practice BDSM. Among the panelists was psychiatrist Richard Krueger, whose expertise included the diagnosis and treatment of paraphilias and sexual disorders.

During the meeting, Wright says, “I brought up the point that the DSM manual caused harm to BDSM people because it perpetuated the stigma that we were mentally ill. [Krueger] heard me and said that was not what they intended with the DSM.” Krueger, it turned out, was on the APA’s paraphilias committee, and following the meeting opened up an email dialogue between Wright and the other committee members, in which Wright provided documentation about the violence and discrimination kinky people experienced. “I credited that to the DSM,” she says. “Courts used it. Therapists used it. And it was being misinterpreted.”

Over the next year, “I sent him information, he gave it to the group, they asked questions, and I responded. It was very productive,” Wright recalls. “We [the NCSF] felt we were heard, we were listened to—and they took [our arguments] into account when they changed the wording” of the DSM in 2010.

003

Another major factor in the NCSF’s favor was a paper, co-written by sexual-medicine physician Charles Moser and sexologist Peggy J. Kleinplatz and published in 2006 in the Journal of Psychology and Human Sexuality, titled “DSM IV-TR and the Paraphilias: An Argument for Removal.” According to Wright, the paper, which “summed up opinions of mental-health professionals who thought you shouldn’t include sexual activity in the DSM,” played a significant role in the paraphilia committee’s eventual shift in language.

In February 2010 the proposed change was made public—clarifying, Wright says, that “the mental illness [depends on] how it is expressed, not the behavior itself.” The new guidelines drew a clear difference, in other words, between people expressing a healthy range of human sexuality (for example, a couple that likes to experiment, consensually, with whips, chains, and dungeons) and sadists who wish others genuine harm (for example, tying and whipping someone in a basement without their consent).

The DSM-5 was released in May 2013, its contents marking a victory for the NCSF, Bannon, and Baldwin. The final language states: “A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not necessarily justify or require clinical intervention.”

“Now we are seeing a sharp drop in people having their children removed from their custody,” Wright explains. Since the change, according to the NCSF, less than 10 percent of people who sought the organization’s help in custody cases have had their children removed, and the number of discrimination cases has dropped from more than 600 in 2002 to 500 in 2010 to around 200 over the last year.

“The APA basically came out and said, ‘These people are mentally healthy,’” Wright says. “‘It’s had a direct impact on society.”

Complete Article HERE!

The Pill That Prevents HIV Is As Safe As Daily Aspirin

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.

By

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!