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



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.


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). 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!

The Thrill Is Gone

Name: Billy
Gender: Male
Age: 46
I have heard it’s normal for sex drive to diminish as you age. I’ll run this by you. I’m a 46 year old male and the last time I was at a strip club with bare boobs bouncing around me, you may as well have rolled a grapefruit across the floor. Actually, I can see more use from the grapefruit. I don’t recall the last time I did it, and jerking off was almost disgusting. My tool has shrank to nothing. I barely touch it and it just dribbles, it doesn’t fire off anymore. I don’t even like to touch it to go piss anymore. I’ve had to shave around it, so I actually find it, to keep from pissing my pants. Is this normal?

No, Billy, this isn’t normal. I think you already know that too, right?

andropauseDo you know anything about andropause? If not, you ought to. Here’s what I suggest. Use this site’s search function in the sidebar. Type in the key word: “andropause” and you will come up with a wealth of information about this issue.

You can also use the CATEGORY pull down menu. Look for the subcategory: Sex and Aging, under the main category: Aging. Everything is alphabetized.

But for the time being, here’s a typical question and response —

Name: Wilson
Gender: male
Age: 58
Location: Lancing MI
I’m a successful entrepreneur, in decent health (I could stand to lose a few pounds.) I have just about everything a man could want in life, but I’m miserable. I have no energy and I feel like I’m sleepwalking through my life. I have no sex drive at all; my wife thinks I’m having an affair…I wish. Even Viagra doesn’t do the trick anymore. Is this just old age, or what?

Old age, at 58? Middle age, perhaps! Regardless what we call it, you sound like you’re in the throws of andropause — male menopause — ya know, the change of life!

Never heard of such a thing? You’re not alone. It’s only been recently has the medical industry has begun to pay attention to the impact changing hormonal levels has on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!andropause-1

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.

While most all of us have heard of a mid-life crisis, and it’s tragic consequences — red convertible sports cars, comb-overs, and the trophy wife or lover — fewer have heard of andropause. A mid-life crisis is essentially a psycho-social adjustment to aging — bored at work, bored at home, bored with the wife or partner — that sort of thing. Andropause, although it may coincide with a mid-life crisis, is not the same thing. Andropause is a distinct physiological phenomenon that is in many ways akin to female menopause.

Unlike women, men can continue to father children after andropause, but like I said, the production of testosterone diminishes gradually after age 40. I suppose you know that testosterone is the hormone that stimulates sexual development in the male infant, bone and muscle growth in adult males, and is responsible for our sexual drive. But did you know that by the age of 55, the amount of testosterone secreted into our bloodstream is significantly lower than at 45. And by age 80, most male hormone levels have decreased to pre-puberty levels.

Men, are you over 50? Are you feeling weak, lethargic, depressed, and irritable? Do you have mood swings, hot flashes, insomnia, and decreased libido, like our buddy Wilson, here? Then you too may be andropausal. You need to get some lead back in your pencil!

mutateAll kidding aside, andropausal men might want to consider Testosterone Replacement Therapy (TRT). Ask your physician about this. Just know that some medical professionals resist testosterone therapy, mistakenly linking Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. However, before starting a testosterone regiment, insist on a complete physical, including blood work and a rectal examine. Mmmm, rectal exams!

Testosterone is available in many forms — oral, injectable, trans-dermal and by way of implants. The oral form is not recommended because of the high risk of liver damage. But injections, patches, pellets, creams and gels might be just the answer. I encourage you to be informed about TRT before you approach your doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Good luck

20 Interesting Facts You Never Knew

Everyone took a sexual education course in middle or high school to learn about the “birds and the bees.” However, there are a lot of facts that sex ed teachers leave out. These facts are sometimes the most interesting and the most useful in real-life situations. Here are 20 little known facts about “doing it.”

Patterns In Sexual Desire

Most women have an increase in sexual desire around the time that they ovulate each month. This is nature’s way of making sure the Earth stays well-populated.

It Sounds Gross But…

Semen can be great for the facial pores and can even help with acne. The male-produced “facial cream” can also prevent wrinkles.


A Headache Is A Bad Excuse

We’ve all heard the cliche “my head hurts” excuse for turning down sex. However, sex often helps with pain, especially with headaches.

We’re Not Judging

Many straight men enjoy having their anal areas stimulated, and that is totally okay! Sexual experts say that the anal areas are packed full of nerves and can make a male orgasm so much better.

1, 2, 3…And They Keep Coming!

Women can orgasm an unlimited amount of times. Men generally need a period of time after orgasming to recover. However, women need barely any time and are ready to go as many times as they please.

Men Are Erect…A Lot

It is said that many men experience about 11 erections every single day. While they may not be raging every single time, it does happen pretty often.

Celery Can Arouse

Yes, celery. The pheromones in celery can cause arousal in men. In addition to the arousal, the vegetable also makes men who eat it more attractive to women.

The Left Side Is The Best Side

A group of scientists found the upper left quadrant of the clitoral head is the most pleasurable spot to touch. So, it’s okay to tell him to go “a little to the left.” It’ll be sure to make the sex even more enjoyable.

Orgasms Are Different

A man’s orgasm lasts about 22 seconds while a woman’s lasts about 18. It is also very common for it to be uncomfortable to pee after having sex because of an antidiuretic hormone that prevents urine from freely flowing.

Sex Can IMPROVE With Age

Sexual attraction is a life-long drive. The reason most older people don’t have sex very often is that there is a lack of opportunity to have sexual encounters.

Get Your Heart Going

Sex is a great way of getting in your daily cardio exercise. During an orgasm, heart rates can reach between 140 and 180 bpm.


Lube Can Make A Difference

While lube is considered a sex tool for older people, many sexual experts say that a little lubricate can make the difference between pain and pleasure during sex. This doesn’t mean the woman is not turned on. Natural “lube” can come and go without any warning.

Penetration Is NOT The Secret

Most women do not orgasm from penetration alone. The majority of women need some type of clitoral stimulation to reach their climax. It has nothing to do with size or penetration.

Everything Expands

The penis is not the only thing that grows during a sexual encounter. In fact, the testes grow by 50% and the vagina can double in size when aroused.

More Sex Makes You More Appealing

After having sex, a woman’s estrogen levels double. When estrogen levels are higher, a woman’s hair can look shinier and her skin can even feel softer.

Not Only People Can Be Arousing

Some people have sexual attraction to objects instead of specific people. There is a woman known to be sexually aroused by the Eiffel Tower.

Have Sex, Live Longer

Scientists have found that orgasms can actually prolong your life. That’s right, the more sex you have, the longer you can live.

Humans & Dolphins Alike

As far as sex is considered, dolphins and humans have one key fact in common. The two mammals are the only animals in the world that have sex for pleasure.

Sex Everyday Keeps The Doctor Away

Sex can actually help you stay healthy. Many doctors believe this is because sex can lower blood pressure and greatly decrease stress levels.

It’s Like Two Puzzle Pieces

Not every penis, or vagina, is the same. If a guy is too large, women can control penetration by changing positions. If he is too small, there are many toys, etc that couples can invest in.


A Farewell to a great man

Dear sex fans,

I realize this is a bit off topic for this blog, but I want to acknowledge the death of famed British neurologist and author, Oliver Sacks.

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City. (Photo by Nancy R. Schiff/Hulton Archive/Getty Images)

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City.

In February, he wrote an op-ed in The New York Times revealing that he was in the late stages of terminal cancer, after earlier melanoma in his eye spread to his liver.

“It is up to me now to choose how to live out the months that remain to me,” he wrote. “I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.”

Earlier this summer I read Dr Sacks’s memoir, On the Move.  I love it.  It’s an interesting memoir by a fascinating personality.  And while reading I discovered that we had a dear friend in common, Thom Gunn.  What a small world!  So I decided to send him a note.

Dear Dr Sacks,

I just finished reading your memoir, On The Move.  What an amazing life you’ve lived.on-the-move-by-oliver-sacks

Of all the marvelous things you’ve done and all the fascinating people you mentioned in your book nothing surprised me more than your close friendship with Thom Gunn.  I was a friend of Thom too and I lived directly across Cole Street from him.  I moved to the flat at 1207 Cole Street in 1979.  At the time I was working on my doctorate in clinical sexology at the Institute For The Advanced Study of Human Sexuality in San Francisco.

I didn’t know Thom well at first.  However, I would regularly see him walking both in our neighborhood and elsewhere in town.  He was always in his leathers, rain or shine, and used to think to myself, “What a mensch!”

It finally dawned on me that he lived across the street from me.

Once he saw me in my roman collar.  (I was ordained a catholic priest in 1975 at the age of 25 in Oakland, CA.  I had come out to my local superiors; I was a member of the Oblates of Mary Immaculate, before I was ordained.  Like I said, I was working on my doctorate to become a sex therapist and prepare for an upfront gay ministry.)  Thom smiled at me when he saw me; I blushed and told him what I just told you.  He was fascinated, but I also believe he thought I was a twit.  He probably was right.

I knew nothing about Thom other than he was my neighbor.  Then one day I was in a bookstore on Haight Street and there was a photo of Thom in the window advertising a reading.  That’s when I started asking around about him.  Despite his cult status within the gay community, he was the most unassuming person.  I was honored to have a personal connection with him.small_front

I finished my doctorate in 1981.  My dissertation, Gay Catholic Priests; A Study of Cognitive and Affective Dissonance was directed by Wardell Pomeroy.  A firestorm of media attention followed.  The media branded me as THE gay priest, as if.  I think Thom read about me in the New York Times because next time he saw me he clapped me on the back and said, “Well done.”

No sooner did I complete my doctorate, and because of the media attention my public coming out caused, the leadership of my religious community in Rome began a process of dismissal against me.  I was devastated and lost.  I was even getting death threats.  Thom was always so supportive and encouraging.

I fought the church for the next thirteen years in an effort to save my priesthood and ministry.  Alas, the writing was on the wall back in 1981 and it was only a matter of time till they had their way with me.  I wrote about the travail in a book that was published in 2011, Secrecy, Sophistry and Gay Sex In The Catholic Church: The Systematic Destruction of an Oblate Priest.

Thom was always so solicitous about my wellbeing.  He knew how difficult life had become for me.  And both of us found ourselves on the forefront of caring for friends who were dying of AIDS.  One of my landlords died in 1986.

Thom introduced my housemate and I to Augie Kleinzahler and his girlfriend, Caroline Lander, who lived only a few blocks from us in Cole Valley.  We all became great friends and copious amounts of strong drink were consumed.  I wonder, do you know Augie?

When Thom turned sixty I surprised him with a homemade German chocolate cake.  I told him he was the oldest person I knew.  This made him laugh and he called me a whippersnapper.

In 1992 the surviving landlord sold the Cole Street duplex and I and my housemate moved to Oak and Ashbury.  Sadly, I didn’t get to see Thom as much as before.  I move up here to Seattle in 1999 because I could no longer afford to live in SF.  I was deeply saddened to learn of Thom’s death in 2004.  He was such a great guy, what a marvelous soul.

Again, thank you for your memoir; it was grand getting to know you on a personal level.  I read The Man Who Mistook His Wife for a Hat when it came out in the mid-eighties and loved it.  But I never guessed you and Thom knew each other or that you actually visited him when I lived across the street from him.  What a small world.  I wish I had known you back then.

Anyhow, thank you for the bringing me this unexpected flood of memories of Thom.  I wonder what he would have made of yesterday’s Supreme Court decision (Obergefell v. Hodges).  I contend that we got marriage equality only because we walked through AIDS first.  I think Thom would have agreed with me.

All the best,

Richard Wagner, M.Div., Ph.D., ACS

To my astonishment, Oliver wrote back; I mean that literally, a handwritten note.  Apparently, he never used a computer.

Dear Dr. Wagner (can I say Richard?),                                                          6/60/15

I am greatly interested and greatly moved, by your letter — your courage in being honest and forthright, at a time and on a subject bound, sooner or later, to cause your ejection from the priesthood. In another few years perhaps, with Pope Francis at the helm, these last bastions of Catholic bigotry may have fallen.

I like to think of you as living across the street when I visited Thom, and glad to know that he appreciated you and your works. I still miss him deeply — there were not too many people with whim I could be entirely open — and I like to think that his ghost is pleased that my title came from his poem. (I find it a huge relief being open now to all and sundry {Oliver came out earlier this year} — I am so glad I completed my book before I became ill).

And what a liberation, an affirmation for us all that the Supreme Court voted as it did. I suspect that Ruth Bader Ginsberg, quite ill now, stayed on to ensure the 5/4 decision.

Thanks for your letter and my very best wishes,


Oliver Sacks01     Oliver Sacks02

Click on this link to see a copy of Oliver Sacks’s note.

Thank you Dr Sacks and farewell!

New Mommy Woes

Name: Megan
Gender: Female
Age: 29
Location: Toronto
I’m a new mother and this is my first child. He was born 3 weeks ago, but I am still enthralled with the miracle of it all. So far motherhood has been pretty wonderful. Sure I’m tired, but just holding my son in my arms makes me so happy I sometime cry with the joy. There is a problem, however, my husband wants to resume our sex life, but I have absolutely no interest. I love him dearly and I know I owe him this, but I have no libido. What can I do?

Yep, this is common enough complaint. This is precisely the place where new parents experience the most strain on their relationship. And when you think about it, it’s not all that surprising. Most new mothers are exhausted by the expectations of motherhood. And first babies are the most challenging. Added to these burdens her partner eagerly awaits the resumption of the sort of sex life that was in place before the pregnancy. New mothers often feel like their husband is just one more person to service, one more person with needs and demands that are keeping her from much-needed sleep.

New Mother LoveNew mothers can find sex unappealing for reasons both physical and emotional. If you’re breastfeeding, your breasts are sore, heavy, and leaky. Your body just doesn’t feel sexy, with its stretch marks, cellulite, dark nipples and dark line down the abdomen, not to mention the weight gain and varicose veins. Then there is lochia, the discharge after the birth, which lasts for 3 to 4 weeks and does not smell very good. If you had an episiotomy, the stitches are very uncomfortable and you may worry about infection. Your hormones may still be in a state of flux, so you feel moody or depressed. And you may not have a good method of birth control, so sex is the last thing on your mind!

Some doctors recommend that new mothers refrain from sex until their first post partum examination, usually about 6 weeks after the birth.NewMother

So if you and your husband weren’t warned about all this, you’re probably both totally unprepared. And if you can’t talk about it, there will be trouble ahead. Many new fathers labor under the misconception that once the baby is born, their sex life will return to normal. Besides this being completely unrealistic; it mostly puts pressure on the wife to do, as you suggest, her ”duty”. This is no way to pursue a sex life together.

Of course, new fathers can help their partner move beyond those feelings of sexual disinterest by being an involved parent and helping around the house.

There are loads of sex things new mothers can do that will pleasure their partner that don’t involve full-on fucking. Hand jobs and blowjobs are always welcome. Reading erotica aloud to each other can be fun. Mutual masturbation, or even watching him and cheering him on as he squeezes one out is also an option. But probably the thing that will get your libido back is a lot of touching, massaging, hugging, kissing, and snuggling and not as a prelude to sex, but just for the joy of it. These things, without the pressure to perform will help reestablish the pair-bond between you and your old man, which will inevitably lead to the long awaited fuckfest.

Good luck

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