Let’s cut through all the usual confusing debate about PrEP and condoms and state the facts & what your options are.
What is safe sex? since you only need one exposure to get HIV whatever’s protecting you has to be in place all the time before anything happens. With something as high maintenance & disrupting as HIV one once is too many.
The key? be “Ready and Waiting” Even if you go on for hours, are wild and push the envelope, the defense must hold.
- Clearly not condoms. Made of rubber that deteriorates, especially when stored on docks in heat, with no enforcement or education about expiration dates, and data showing wildly varying breakage rates of 20%-40%. Have to be pulled out and put on after a few drinks or tokes, in the heat of passion when any delay of a few seconds means dikus limpus. Has to last through punishing banging, stretching and that last huge thrust. Hah!
- Clearly PrEP is the answer. Four tiers of HIV testing in the first months ensure you’ve not one bit of HIV in your body - for if you did you’d have to take meds far more powerful than PrEP and ensure medical monitoring far more intense - for life. So far nationwide as reported in the last national conference no case of seroconversion has occurred where Truvada is taken daily. Zero. That’s safety.
Taking it through Yale, Boston’s Fenway, or NYC’s Callen-Lorde means you get the plus of mandatory STD testing as well as blood testing to ensure the body is coping with Truvada without any bad effects. Most STDs if caught in the first 6 weeks - the average with 3 month testing - are cured with meds immediately. The PrEP program vaccinates and protects through preventive innoculations against a huge variety of STDs. And you have a baseline for comparison if something does come to light - an essential for fine-tuned medical intervention.
At this point you should be comparing the risk run with PrEP to the risks you run crossing a NYC street - even at the corner, driving, flying, hiking, biking, running, walking, exposing yourself to any commercial space if not wearing rubber gloves and a surgical mask. In other words the ordinary risks of daily life are now far, far higher than the risks you run after being on PrEP.
A person on PrEP is about the safest person to go skin on skin with you could ever pick.
Next least risky is a person with HIV whose blood tests quarterly confirm the virus is undetectable. Their AiDS medications are doing in an infected state what Truvada is doing in an uninfected healthy state: keeping the virus at bay.
And who is the most dangerous person to have sex with? the person who only took one general HIV test 3-6-12-x months prior, a test which only tested one type of possible virus infection, which would have had to have occurred - ages ago. If their protection is a condom that’s been sitting on the pier for months, in a hot storage closet for more months or a year and then in a wallet or hot pocket you’ve definitely got a 20% or 40% chance of being totally unprotected due to breakage.
Given the fact that your potential partner on the average uses a condom all the time only 14% or most of the time 11% - a total of 25% means you've got your finger in the dyke by the dyke is majorly breached. Add the fact that on the average 28% use them rarely and 27% use them not at all - a total of 55% - you’ve no longer just playing Russian Roulette with 1 or 2 bullets in the chamber, your chances are well towards 60% that you’ll get the bullet on that first time it breaks.
The whole condom system has broken down because of the inherent breakage rates before any use is made of them on top of the fact that the general population has abandoned their use. Why? simple: they don't feel good, they're expensive, they're hard to put on - the list of inconveniences is long.
If you are relying on a condom you are gambling that a rubber membrane that breaks 20-40% of the time will protect you against people who are having mostly unprotected sex most of the time.
While most people are stuck with outdated and failed strategies, guys on PrEP are relying on carefully managed and supervised technology under careful scrutiny so they can have bare skin-on-skin sex with full feeling - again enjoying one of life’s most magnificent delights - and doing so as totally protected as one can get in today’s modern times.
Hard to get on PrEP? just go to the PrEP clinics and if you've had unprotected sex in the past 48 hours tell them that - and they'll put you on PEP - Truvada + one more drug for one month. That's the day-after pill.
Then if you're still neg after one month you can move on to PrEP, Truvada alone.
Affordable? once you run through your deductible and out of pocket max the insurers cover everything. If it's too expensive for you these PrEP facilities are expert in finding a way to cover your cost. And it's a lot more sure that'll happen if you're already on the program.
Once on it, you'll find you've lost that feeling of always being afraid, worried, looking over your shoulder - having simple decisions become life-shaking ones. You've protected yourself - and those you sleep with - without relying on outmoded technology and changing people's behavior in bed. Yes, with PrEP you can sleep soundly once again.