Box Turtle Bulletin

Paul Douglas

January 24th, 2016

Analogous to the “pro life” folks who are opposed to birth control availability and education. They aren’t pro-life, they simply want people to follow their moral ideology. If they really wanted to avoid abortions, they would be adamantly trying to prevent unwanted pregnancies.
Its the same thing here, IMHO.

enough already

January 26th, 2016

My husband and I have been in a monogamous relationship for well over 3 decades now. We’re both HiV-.
The nasty comments some professional gays have made to me (some even here!) about our high-risk behavior of barebacking have cured me of any skepticism I’d otherwise bring to such blog post.
Wow. Just, wow.
They people really do want those gays who don’t see the world through their eyes to become ill and die of Aids.
(Seroconvert is too PC a word for what these people want to happen).
Condoms are universally despised and seldom used. Anything which prevents the spread of this pandemic and is accepted and used is worth encouraging.

Priya Lynn

January 26th, 2016

“They people really do want those gays who don’t see the world through their eyes to become ill and die of Aids.”.

Really, stop with the B.S. already.

“Condoms are universally despised”.

Absolutely absurd. Neither me nor any of my ex partners despised condoms.

If you want people to take you seriously stop with the ridiculous B.S.

enough already

January 26th, 2016

Priya,
We’ve been down this road many times and it always turns out that you’re one of the few people on the planet who like condoms.
Facts remain facts regardless of your personal distaste for my viewpoints.

Eric Payne

January 27th, 2016

enough already,

I guess I’m one of the “professional gays” (whatever the hell that is) you believe actually, purposely, wish on you and your partner death from AIDS.

Paranoid much?

So you’re both poz? As far as I’m concerned… BFD. I’m assuming you are both legally adults and that you both are blessed with a level of intelligence that allows you to make informed decisions regarding your personal medical care.

I really don’t care if you’re going bareback or covering yourself with a triple layer of condoms; it’s your and your partner’s relationship. How you express the physicality of that relationship is entirely your business. If the two of you are happy together, go at it and enjoy.

What I care about are the people who are positive and play outside of — or in lieu of — a relationship. Already, too many oersons either fail to disclose their HIV status to sexual playmates (and, too often, don’t know, themselves, their HIV status and presume themselves to be negative).

That’s my fear with PrEP — people will return to the lackadaisical attitudes pre-AIDS. Remember, it was a group of less than 100 men, on two separate sides of the continent, from which AIDS took hold and decimated an entire generation — OUR generation — of gay men. Millions marked for death by the simple transmission of a viral agent in a closed community.

Last time, it was an act of Nature. What if, next time, it’s not? What if one of those bat-shit crazy anti-gay governments in Africa thinks they can really “kill the gays” without needing to arrest and sentence them? That they could just cook something up, infect a handful of gay men in custody then release them?

Outside of a monogamous relationship, condoms should always be used.

Priya Lynn

January 27th, 2016

Enough already said “Facts remain facts regardless of your personal distaste for my viewpoints.”.

Yes and I wish you’d stick to the facts for a change. For example, I don’t dislike your viewpoint, I dislike the absurd statements you make when expressing it.

Priya Lynn

January 27th, 2016

Eric, Enough Already said he and his partner are HIV negative.

Unlike Enough Already suggested, it’s a very rare person that thinks they should use condoms being in a monogamous relationship.

Oggbert

January 27th, 2016

Honestly, peoples personal like/dislike of condoms (and actual usage/non-usage of condoms) seems a bit beside the point. HIV infection rates in the US raising, particularly in the younger gay populations.

I think the “only condoms” message is not really working, particularly with young MSM. Impulse Group, which is 100% funded by AHF to advance safe sex awareness, and HIV testing and prevention in young men, recommends they speak to doctors about PrEP, even offering documents to take to the doctor for education (though, as far as I can tell, they are mostly about testing and education).

Perhaps ironically (given the last post on PREP), Impulse’s events and ads tend to look like circuit parties with lots of alcohol – drinking is one behavior that seems to impact condom use.

Oggbert

January 27th, 2016

Eric Pyane – yet in the real work, condoms alone have less efficacy than PREP – only about 70% when used consistently. PREP, when used consistently 4-7 times per week has a minimum efficacy around 85%.

Some mathematical models predict that 50% of new infections in Ontario during the modeling period where caused by condom failure and even the authors admit they are likely using a condom failure rate that is too low (87% efficacy – the efficacy for vaginal use).

This doesn’t mean condoms should not be used, but that PREP, condoms, and treatment for those who are positive are likely a winning combo, something even AHF funded groups seem to believe.

Timothy Kincaid

January 27th, 2016

Oggbert,

I believe your numbers are a bit low. PrEP, when used consistently 4 times per week has an efficacy around 96%. It increases with increased adherence. In those taking PrEP daily, the efficacy is stated to be 99% (in medicine, 100% is seldom used, and 99% in this case means “in excess of 99%”)

There have been, to date, no documented cases of anyone seroconverting while using PrEP daily.

Priya Lynn

January 27th, 2016

“I think the “only condoms” message is not really working”.

I think very few people are advocating a “condoms only” message.

Oggbert

January 27th, 2016

Hi Timothy,

I understand where you get the 99% number, it is from the iPrXe-OLE study. It is important to understand that that it is a statistical number that comes from the use of regression model based off of the iPrEx study, so when they account for the statistical uncertainty of the model, the finding is that “[t]his 100% efficacy translates into a /minimum/ efficacy of 86% if the statistical uncertainty of the result is taken into account.”

Oggbert

January 27th, 2016

Priya – I think a reasonable person could believe that the higher ups at AHF are saying just that by opposing access to PrEP whenever they can and then doing their best to make it something shameful to use.

I think Eric Payne for instant is pretty clear that that is his stance, and even if he is part of a minority, it is a very loud (online at least) minority.

To be fair, I believe people should use condoms, but I also think that people need to understand that condoms fail and are not 100% effective. Adding PrEP to condom use adds an additional layer of protection, and for the many men (60% in one study men who use dating/hook up sites) who do not use condoms every time, it can offer additional protection that was not available in the past.

Priya Lynn

January 27th, 2016

Oggbert, Eric Payne didn’t take any such stance. You are reading into his post something he didn’t write. I’ve had several people do that to me on this site, claiming I oppose the use of Prep when that’s not at all the case.

enough already

January 27th, 2016

Erik,
We’re negative. That’s what HiV- means.
We’re monogamous.
As to the danger of gay men not using condoms because of a preventative measure which is virtually 100% effective…huh?
Condom use is rejected by young gays for the same reason young straight men don’t use them, nobody likes them, apart from a very few very loud voices on this forum.
The whole ‘use condoms’ movement has failed, utterly, totally and horribly.
I think you have something against anal sex and you’d get much further if you were honest about it.
Religious objection?

Eric Payne

January 27th, 2016

If something works, use it.

But as far as I’m concerned, the jury is still out on PrEP — especially when the question of decades-long usage is considered.

I’m not a doctor, nor am I a microbiologist. I am, however, a pretty intelligent guy, and can understand how things do, and do not work.

Go read the literature on PrEP made available by the drug company(ies) who manufacture PrEP. Go ahead. I’ll wait…

OK. Welcome back. Did you notice what it said… or, more importantly, what it didn’t say?

It didn’t say it “kills the HIV virus” or even that it’s okay to use PrEP all by itself.

Instead, it says it operates by effectively blocking the virus’ ability to replicate.

It doesn’t say PrEP weaves an invisible, microscopic filter over the head of someone’s penis, which will completely block the virus from exiting the body of Person 1 and entering the body of Person 2 during sex. Instead, it says PrEP is to be used with condoms.

From personal experience, I know that long-term consistent usage of any medication too often requires larger dosages of the same medication to maintain the benefits of that medication, if not a second, separate, medication for continued efficacy.

Hopefully, when it comes to HIV, in another thirty years it has been obliterated… but what if it’s not? After all, the flu virus still makes its annual visits, each new year bringing a slightly mutated version of an earlier influenza iteration.

If HIV is consistent with the behavior of other communicable viruses, then that also forewarns that PrEP efficacy, long-term, has yet to be determined.

In short, my stance is: Want to use PrEP? Go for it. Have fun. But don’t JUST use PrEP.

Timothy Kincaid

January 27th, 2016

Eric,

I have discussed here before your campaign of misinformation about PrEP. But here you are again seeking to muddy the waters and confuse people about PrEP.

I don’t know the reasons for your efforts to deceive, but please know that they are not welcome.

Previously you tried to confuse people by pretending that the language around the use of Truvada as ARV applied to use as PrEP.

Now you are here with a bunch of “it doesn’t say” statements and insinuations to imply things about PrEP that are not true.

No, the language does not say that PrEP weaves a magical invisible filter. It needn’t say that. It doesn’t do that.

What PrEP does – which you avoid mentioning – is prevent the virus from taking hold in a body. It prevents infection.

Let me say that again: daily use of PrEP prevents the transmission of HIV

As for all the nonsense about requiring dosage, that applies to treatment, not prevention. It would be as logical to argue that long term usage of condoms requires you to wear two or three of them. It’s just irrational fear-mongering.

Your insinuations are based not in science, not in fact, not in a desire to staunch the pandemic, but appear to be based in some effort to confuse others. I find it despicable and wish you would stop.

Gossar

January 27th, 2016

Condom companies have not gone out of business — enough people are buying them.
Local shops are having to keep them under lock and key to deter shoplifting — some people are wanting them.
Coney Island whitefish litter the bushes and alleyways — somebody is using them.

Even if you personally despise condoms, don’t dismiss the very existence of people whose feelings on the matter are less violent than your own.

enough already

January 27th, 2016

Gossar,
I would far rather see people use condoms than get infected with HIV.
That doesn’t change the fact that all efforts to get gay men to use them in the last 30+ years have been dismal failures.

Gossar

January 27th, 2016

The combined use of TARP and PrEP is currently our best hope at stopping the HIV pandemic. Access to both should be much more widespread than they are now.

That doesn’t change the fact that neither drug regimen does anything at all to stop the increase in multidrug resistant gonorrhea from becoming the next bugbear with which to demonize gay sex.
http://www.webmd.com/sexual-conditions/news/20120606/untreatable-gonorrhea-on-the-way

Anyone responsible enough to use PrEP for HIV prevention outside a monogamous relationship should also be able to listen to the risks and make an active decision on condom use without moralizing judgement.

To recap: MSM sex, great; HIV, bad; PrEP and TARP, good (and woefully under available)
Repeating, “Condoms don’t work” takes us off-message.

Eric Payne

January 28th, 2016

Tim Kincaid writes, in reply to my comment:

Let me say that again: daily use of PrEP prevents the transmission of HIV.

No, Tim, it doesn’t.

It prevents the replication of HIV — and, yes, that can be considered much the same. If the HIV is prevented from replicating/reproducing, it remains harmless.

You seem to be intelligent, so think this through.

Person A is infected with a contagious agent, but that agent can only be transmitted via Person A’s body fluids. The infectious agent, itself, is of subatomic size and, when dormant, hides in the blood, and some specific glands/organs of Person A.

Person B is uninfected.

To promote personal health, Person B ingests an oral medication that prevents replication, in Person B’s system, of the contagious agent.

Person A and Person B “exchange body fluids.”

Now… about viruses.

A virus is one of the smallest, most basic, living organisms. It exists only to replicate; as long as it has a growth medium, it will remain active.

But they’re pretty much impossible to kill. Viruses will become dormant, if their growth medium is no longer available to them, or they are frozen. They can be altered — the annual flu shot transforming the current flu virus iteration into something less threatening, for example.

But they can’t be killed.

That’s really pretty much basic biology, with a smattering of organic chemistry thrown into the mix.

So I really don’t care how angry you might get because your belief that gobbling up PrEP is challenged.

When you and I “go at it,” Tim, I’m reminded of the very public arguing the community went through in the early ’80s, with a small handful of us on an early bandwagon to promote the use of condoms and to advocate the closing of public sex clubs ad others screaming much more loudly that such measures were intrusive, unnecessary, and a capitulation to rigid social structures.

Use common sense.

The HIV virus is still going to be passed from the infected to the noninfected. PrEP prevents the HIV virus from replicating — that’s how the PrEP literature, itself, describes how PrEP works.

The virus remains dormant. And that may go on forever. But PrEP hasn’t been around “forever.” It’s been around, and been being tested, for about a decade, and it’s proven to be effective at holding down new rates of infection. I concede that.

But, using common sense… what happens to those who are now using PrEP, solely, in 20 years? Are you ready to tell some 40 – 50 year old man, who started PrEP in his late 20s/early 40s… “oops”?

enough already

January 28th, 2016

Gossar,
Can you show me one, single, solitary study which demonstrates that our over 30 year push to get gay men to use condoms has resulted in long-term, consistent use by anything close to a majority?
You can’t because all our attempts have failed and failed utterly.
I’m very well aware of the other STDs and how well condoms reduce the risk of transmission of nearly all of them.
Again – in over 30 years of slut shaming, finger pointing, pretending that condoms are ‘sexy’, yelling, lecturing, begging ‘educating’, we have achieved nothing.

One thing which I really wish everyone here would drop and that is the nonsense about ‘intelligence’. It’s as wrong as can be.

The utter failure to get men to use condoms in any but the most trivial numbers has nothing to do with intelligence of those men who won’t wear them and everything to do with the fact that everyone hates wearing condoms. (Except a vanishingly small group of gay men who deny every survey ever conducted, and love to tell the rest of us they’re the norm.)

PrEP works. Compliance is high enough for it to work. Condoms are less effective in preventing acquisition of the virus, and compliance is awful.

Honestly, how can people ignore reality decade after decade?

Timothy Kincaid

January 28th, 2016

Eric,

I am unaware of any studies that support your assertion that HIV lies dormant in the body of uninfected persons.

And as my position is based on science, not your common sense, I’ll say it again: daily use of PrEP prevents the transmission of HIV.

Here are some other ways of saying the same thing:

CDC “Preexposure prophylaxis (PrEP) is a medicine taken daily that can be used to prevent getting HIV.”

AIDS.gov: PrEP is a way for people who don’t have HIV to prevent HIV infection by taking a pill every day.

World Health Organization: Pre-exposure prophylaxis or PrEP is the use of an antiretroviral medication to prevent the acquisition of HIV infection by uninfected persons.

Your insinuation that the uninfected person somehow has the virus dormant in their body is false and contrary to the meaning of the word uninfected.

When HIV hides in an HIV+ person’s body, It’s not just randomly hiding as free virus. It’s hiding as dormant infected cells. If you’re not infected, you don’t have infected cells, dormant or otherwise, to hide anywhere.

Eric Payne

January 28th, 2016

enough already asks:

Can you show me one, single, solitary study which demonstrates that our over 30 year push to get gay men to use condoms has resulted in long-term, consistent use by anything close to a majority?

And you think taking a pill is going to be any different? If anything, long term, simply taking a pill may, eventually, be utilized even less than condom use.

Think about it. To use a condom requires a certain amount of preparation each and every time — the condom has to be physically opened and fitted. It;s “in the moment,” so to speak, and requires a voluntary thought process each time.

Taking a pill becomes habitual. And, trust me, the longer you take pills, habitually, the more likely you are to forget to take them, simply because it’s habitual — a person simply doesn’t question whether they took it or not.

As for Mr. Kincaid’s comments… I’m done. All I’ll say in reply is: Tim, I really hope you are correct, and in 30 years, there hasn’t been a second wave of death because people put their faith in PrEP, only to discover HIV works like any other virus does.

Gossar

January 28th, 2016

enough already,
According to the most recent National HIV Behavioral Surveillance (NHBS) report, of the urban MSM surveyed only about a quarter reported that their most recent sexual experience was condomless receptive anal sex. No, this does not mean that the other 75% were using condoms; and yes, that article goes on to mention an increase in condomless sex since the previous report 3 years ago; but that’s still a reduction in the riskiest behavior since you were last single nearly forty years ago.
http://www.poz.com/articles/CDC_risk_report_761_28308.shtml

When you say “universally despised” and “absolute failure” I hear you speak in and ask for universal absolutes which don’t exist in reality. It’s fundamentalism like this that drove me to wade into the conversation here (against my better judgement). That same NHBS report shows the situation is much more nuanced. I acknowledge that your experiences are different than mine, please return the favor.

For someone who’s been monogamously partnered on the sidelines for “30+ years,” you literally have no skin in the game. The three decades over which you claim no improvement are the same three decades you’ve spent pair-bonded with a husband who shares your view on barebacking. On the face of it, this sounds like selection bias.

In an effort to return to the subject of this particular post (and assume good faith on your part), I’d like to point out something you may not have realized, that to some people your position shares many common elements with the AHF’s concern trolling but with the opposite polarity—a stridently held opinion, an intolerance of dissent, a personal bête noire, and an absolutist world-view all ostensibly concerning someone else’s life and for their own good.

Again: MSM sex = great, HIV = bad, PrEP & TasP = good (but underused)
If you insist on talking about condoms, let’s address the fact that in contrast to EU guidelines, the FDA mandates more restrictive condom measurements which are uncomfortable for many men. Better-fitting condoms are used more and more frequently. Anything which prevents the spread of this pandemic and is accepted and used is worth encouraging.
http://www.ncbi.nlm.nih.gov/pubmed/9702591

Priya Lynn

January 28th, 2016

You’ve done a great job here Gossar.

Thanks for making it clear how absurd Enough Already’s statemenets are that condoms are “universally despised” and an “absolute failure”.

Of particular note is that if condoms were “universally despised” there wouldn’t be dozens of brands on sale at every pharmacy throughout north america.

Gossar

January 28th, 2016

edit to clarify:
[When men are offered the choice, better-fitting condoms are used more times and are used more frequently than the sizes currently allowed under FDA regulations.]
https://en.wikipedia.org/wiki/TheyFit

[Also, in an earlier comment my confused fingers independently thought “HAART” and ended up typing “TARP” rather than “TasP” for “treatment as prevention”. There’s no way in hell I’m about to discuss the Troubled Asset Relief Program here.]

enough already

January 28th, 2016

Gossar,
I assume good faith from all here.
A few points.
I very much have ‘skin in the game’. I’ve been active in fighting for our rights since the mid-70’s. I was very active in ACT-UP! back when it wasn’t fashionable to be out and loud.
My first husband died of Aids in the early 1980s. My living husband and I used condoms for two years until we were absolutely sure I was (we both were) negative.
I lost many friends and well over one hundred acquaintances to Aids in less than five years.

Nothing in all these years has materially increased the use of condoms above a very low baseline. Despite the extraordinarily positive and glowing endorsements of condoms on this website, anybody who actually reads gay blogs, anybody who reads CDC data knows darn good and well that the nasty things are disliked by virtually the entire male world.
You folks are an extraordinarily unusual group and, were you to be honest, you’d admit that your passionate endorsement of the wonders of condoms is driven by your desire to get men to wear them, not by the slightest enjoyment of them.
Look – I saw the brilliant minds in Europe and the US invest tremendous amounts of effort in persuading gay men to wear condoms.
As total failure.
PrEP, on the other hand, is already working miracles – San Francisco is talking about an end to the epidemic in the mid-future.
There’s no point arguing – I’m for the method which works, you’re for a method which has been rejected nearly universally.
It’s that simple.

Priya Lynn

January 28th, 2016

EA, you have no idea how many gay men use condoms. You absurdly claimed they were “universally despisted” and “an absolute failure” and you were obviously completely wrong about that. Obvisouly you’re completely wrong in now saying they are “disliked by virtually the entire male world” – absolute nonsense!

And you have no idea whether or not condoms are not used “above a very low baseline”.

You’re just making sh*t up as you go.

Shut up already.

Priya Lynn

January 28th, 2016

If condoms were as unpopular as EA claims they would have stopped making them decades ago.

Gossar

January 28th, 2016

Yes, you’ve seen things. Yes, you’ve done things. Yes, you have an opinion. You’ve found a solution for yourself that does not involve those nasty condoms. But no, as a result of that solution it is no longer your actual skin at risk. Not everyone else can say the same.

HIV bad. PrEP good.

enough already

January 29th, 2016

Gossar your position that I have no skin in the game is nonsense.
Were I to follow your logic, then I shouldn’t fight for the rights of transgender people.
Nor should our transgender neighbors have helped my first husband and I as they did when he was dying.

It’s a particularly insidious form of PC.

Maybe it’s an age difference. My generation saw so many die that those of us who survived tend to embrace any medical preventative measure which works.
We also tend to distance ourselves from the right-speak=right-think nonsense which doesn’t.

You and Priya and Eric are right to champion anything which lowers the risk of sexually transmitted disease.
You’re wrong to keep pretending that men like condoms as a group; you’re making a big mistake in denying the emperor has no clothes on this matter.

Look, we’ve been having this ‘condoms save lives’ conversation for over 30 years and everytime one of us points out how bad compliance is, someone like you three goes all heavy on their ass. And not in a good way.
It hasn’t improved compliance, in fact, it’s down.
It hasn’t made condoms more than about 80% effective in real use (better than nothing, but compare that to a car with brakes which only work 4 out of 5 stops…and you never know which of those 1 in 5 braking needs will be to prevent a fatal crash.

PrEP is virtually 100% effective. Compliance is higher than condom use.

Why are you focusing on fighting me on something which even you yourselves admit has poor compliance? Why are you insulting a man who saw his husband and nearly all his friends die by saying I have no right to be interested in ending this epidemic?
Why the opposition to Truvada? There’s neither medical nor rational basis for it.

Oh, and as to the ‘good faith’…seriously, Priya? You’re increasingly making it clear that your opposition is driven by your dislike of me, not facts.

enough already

January 29th, 2016

This site needs an edit funcition, desperately.
Gossar, one point I didn’t get into my last post which I consider to be important.
You argue that I have no standing because I’m married and monogamous.
While I plan and hope to spend the rest of my life in a monogamous relationship with my husband, what if that were to change? Do I only get to decide on the inefficacy of condoms and the 100% efficacy of PrEP then? Seriously?
If we follow your argument to the rational conclusion, the only people who should be permitted to decide are the bottoms who currently have a dick up their ass, no?
Come on, this is approaching the level of ‘cultural appropriation’ horse-feathers we are currently seeing on some campuses regarding fried chicken and sushi.

Jim Burroway

January 29th, 2016

I have to jump in here and apologize to enough already. I was looking through this comment thread using my iPhone WordPress app and was about to post a reply to the thread in general. But I think I accidently deleted a comment from enough already addressed to Priya Lynn. I logged in on a real computer and cannot find that comment — there’s no comment in the Pending Approval, Spam or Trash folders from enough already, so I don’t know what happened. Again, my apologies.

(And yes, this site could use a good edit function — along with a lot of other upgrades.)

enough already

January 29th, 2016

No problem, Jim.
Basically, we’re just having the same discussion we’ve been having for over 30 years now.
I’m in my fifties. Like nearly all ACT-UP! activists I knew and still know, I advocate for anything which will end the epidemic.
Methods which are contrary to human nature not included.
Methods such as slut-shaming, forbidding barebacking or demanding monogamy don’t interest me.
Condoms are better than nothing, PrEP, with a virtually 100% effectiveness, does.
I’m part of a very small group of men (gay or straight) who are, by nature, monogamous. So is my husband. No surprise it’s genetically determined and we’re first cousins – in a family of whom most of our generation are monogamous, whether gay or straight.
I’m also part of a very tiny group of gay men who survived the early 1980s.
Sadly.

Preaching monogamy doesn’t work. Preaching condom use has-obviously-failed and failed at a very high cost.

I don’t know. It’s hard for me, as one of the oldest people here, to understand why anyone much yes a younger person would be so rigid in their thinking as to reject the facts: Condoms don’t prevent the transmission of HiV very well. Compliance is lousy the dratted things themselves fail far too often.
Truvada, if universally used by sexually active men who are HiV- would end the epidemic quickly.
Sheesh.
Thanks for the apology, I know I’m far, far to the left of you folks here and value your patience with me.

Gossar

January 29th, 2016

enough already,
Pointing out that your literal skin isn’t in the game wasn’t meant to insult but to prove to you that there are people more directly affected by this than you now are. When I hear you use fundamentalist arguments and sweeping generalizations to dismiss our viewpoints, and even our existence, I get angry — much the same anger I imagine you probably feel when AHF tells NHS that PrEP is a bad idea.

The irony is that you’re the one demanding that condom use be everyone and everytime in order to be worthwhile. I don’t hold that binary worldview. Saying condoms aren’t universally evil isn’t the same as demanding everyone use them; and neither position is mutually exclusive to the idea that PrEP is a good thing.

Blunt translation: I came here to support PrEP. Get off your high horse and shut up about condoms; some of us are trying to fuck!

Priya Lynn

January 29th, 2016

EA can’t see beyond his black and white world.

enough already

January 29th, 2016

Gossar,
I reject, utterly, your separation of gay men into entitled to hold opinions and not entitled.

Gossar

January 29th, 2016

enough already, I do not deny you your opinion. I object to your telling me what mine is.

Eric,
If you’re still following this thread, here are some points that might make sense.

A virus requires the cellular machinery of a living host in order to reproduce. In fact, because of this many scientists and philosophers don’t consider viruses to be living. HIV has no will of its own or method of propulsion. So it must randomly bump into the right spot on the right kind of cell and latch on. Until it does so, it is exposed to the host’s defensive immune system.

In the course of a typical HIV infection, the first thing the virus knocks out are the cells responsible for specialized defense against viruses. In the earliest stages however, the body still has a fighting chance. Think of paratroopers going behind enemy lines; their job is to get in, cover their tracks, lie low, and escape detection until severing phone lines, but they are vulnerable while in the air and before they can find a place to hole up.

Consider therefore, that of the finite number of virus particles from the exposure, only a small percentage are going to hit the right receptor on the right cell before running into some other defense. Even after they do they’re still not in the clear.

Once HIV attaches and injects its payload, that’s it. That shell can’t be used again. There’s no going back; it’s a one-way trip. The drugs in PrEP don’t prevent attachment or insertion but they do stop the conversion of viral RNA into anything the host’s machinery can interpret as instructions. So the virus is effectively trapped—unable to retreat and unable to commandeer the host’s cells. The attacked cell triggers a self-destruct and is killed by the body before any new HIV can be assembled or even started. The number of virus particles will never increase above the initial exposure.

Gossar

January 29th, 2016

enough already,
Are we even having the same conversation? Five different times (so far) in this thread alone I’ve said PrEP is a good thing. Yet you still say, “There’s neither medical nor rational basis for [your opposing Truvada].”

I want to try a different way: Can we agree that TasP and PrEP are currently our best hope of stopping HIV/AIDS?

Priya Lynn

January 29th, 2016

Enough already said “h, and as to the ‘good faith’…seriously, Priya? You’re increasingly making it clear that your opposition is driven by your dislike of me, not facts.”.

I dislike you because you ignore the facts! I dislike you because you B.S. to the extreme and then absurdly assert you’re talking facts!

Like Gossar said you keep nonsensically claiming we oppose Prep when the actual stance we both take is that we support its use but advise the use of condoms as well.

Open your eyes for a change!

Gossar

January 29th, 2016

Actually Priya, I don’t think I even said that. My starting proposition was that not everyone at risk for HIV/AIDS sees condoms with the same rancor as enough already.

There have been so many strawmen thrown out that I’ve gone back to finding out if there’s anything at all we can agree on.

enough already

January 29th, 2016

Gossar,
I am not trying to tell you which opinion you should hold. Your position on condoms was proved untenable decades ago and the most current data shows nothing has changed.
But, heh – you’re free to continue to go down that failed route.
I’m glad we do agree on PrEP and TasP.
Just, please, don’t make the mistake of ever telling someone who was in ACT-UP! to shut up.
It’s not going to be well received.
Priya, at least you finally admitted your animus.
‘Bout friggin’ time, too.
Your agenda is clearly to subjugate gay men to your PC priorities.
Ain’t gonna happen. Nevah, evah.

Timothy Kincaid

January 29th, 2016

Gossar said

I want to try a different way: Can we agree that TasP and PrEP are currently our best hope of stopping HIV/AIDS?

Yes I agree. We finally have the tools we need which actually have the power to eliminate this pandemic from our lives.

However, to that I want to add a few other necessities:

1) increased testing for those who “think” they are negative. Most HIV infection comes from those who do not know that they are positive.

2) finding a way to change the attitude/message of the Black Church and Black community (African Americans still are hugely disproportionately impacted by HIV/AIDS)

3) reaching the young with the message of PrEP and protection early enough (those younger than 25 are currently the largest demographic seroconverting)

The medical changes are astonishing and wonderful. Hallelujah!!

But we still have some social work to do.

Gossar

January 29th, 2016

Can we agree that acceptance of PrEP and condom use are independent of each other?

enough already

January 29th, 2016

Gossar,
I certainly can agree that the levels of acceptance are independent of each other.
For decades – the period when there was nothing else, except abstinence – every possible effort was made to convince us that condoms were wonderful and great.
It failed, miserably.
Anytime I see someone push them, I shudder. Decade upon decade upon decade has shown that people won’t use them. Especially the people who should use them.
So – anytime anyone advocates for them I tend to shoot right back – they have a high failure rate, they have a miserable compliance and nearly everyone despises them.

The exact opposite in all three categories applies to Truvada.

Some of my knee-jerk hostility is, to be honest, the result of some of the PC-Nazis here who demand that we evil, sick, preverts (sic) stop barebacking. It wasn’t that long ago that I was told, here, that it was an attack on women for men to have anal intercourse. With other men.

This is a very loaded topic, especially for those of us (I get the impression you’re rather young) who saw millions die while the conservative Christians reveled in their misery and deaths.

So, sure – you keep advocating for condoms and you will keep failing to get the people who need them to use them in appalling levels. But, heh – it’s ok. My background is in the natural sciences and I tend to be a bit more rational about these things. The difference between .99 and .80 for me is enormous. For you, it’s clearly nothing.

I do appreciate your civility toward me. There’s quite a few PC-Nazis around here who demand we gay men subjugate ourselves to their right-speak=right-think demands.

Gossar

January 29th, 2016

There’s no point arguing – I’m for the method which works, you’re for a method which has been rejected nearly universally….

Were I to follow your logic, then I shouldn’t fight for the rights of transgender people….

You’re wrong to keep pretending that men like condoms as a group…

You argue that I have no standing because I’m married and monogamous….

I reject, utterly, your separation of gay men into entitled to hold opinions and not entitled….

I am not trying to tell you which opinion you should hold. Your position on condoms was proved untenable decades ago and the most current data shows nothing has changed.
But, heh – you’re free to continue to go down that failed route.

You show a pattern of telling me what my position is without actually listening to what I say.

Gossar

January 29th, 2016

Can we agree that risk reduction and condom use are not synonymous?
that the goal is measured by reduced exposure and decrease incidence, not necessarily increased condom use?

enough already

January 29th, 2016

Gossar, we certainly do agree that all efforts should be made to end this epidemic.
We got at cross purposes, partially because I’m so used to being attacked here by the PC-Nazis I tend to shoot first and think, not.
And, partially, because I really don’;t think it’s off-topic to be honest – the vast, overwhelming number of men hate condoms. Pretending otherwise has been the key weakness in all these decades of pushing them.
Begin with the truth and you might make progress.

Gossar

January 29th, 2016

the result of some of the PC-Nazis here who demand that we evil, sick, preverts (sic) stop barebacking. It wasn’t that long ago that I was told, here, that it was an attack on women for men to have anal intercourse. With other men.

Yeah, I was here for that. I’ve been reading BTB for a long time.

Can we agree that the statements “condoms aren’t evil” and “everyone must either use condoms or be monogamous” are not the same thing?

Gossar

January 29th, 2016

I take it we agree that the experience of using a condom leaves room for improvement.
Can we also agree that we already know of some things (like fit, materials, and design) that would be a start on said improvements?
I think it’s better to light a candle than curse the darkness, here.

Priya Lynn

January 29th, 2016

Enough Already said “Your agenda is clearly to subjugate gay men to your PC priorities.”.

Oh, this ought to be good. Please enlighten us as to what my “PC priorities” are.

Enough already said “– the vast, overwhelming number of men hate condoms.”

This is the kind of B.S. that EA absurdly calls “facts”. Let’s just here what kind of outrageous B.S. you fantasize about being my viewpoint.

Enough already said “My background is in the natural sciences and I tend to be a bit more rational about these things”.

Give it a rest already! You couldn’t be more irrational about this. You’ve repeatedly accussed Gossar and me of opossing PREP when that’s just a delusion in your blindered mind.

If condoms were as unpopular as you claim they’d have stopped making them decades ago. You haven’t got the slightest idea of how popular or unpopular condoms are, you just think if you blow hard enough that substitutes for facts.

You’re fighting your own personal demons and projecting them onto people who have nothing to do with the assumptions you’re making. Get help.

Priya Lynn

January 29th, 2016

Enough already said “the result of some of the PC-Nazis here who demand that we evil, sick, preverts (sic) stop barebacking. It wasn’t that long ago that I was told, here, that it was an attack on women for men to have anal intercourse. With other men.”.

Your problem is you can’t distinguish between the extremely rare fanatic who would make such a comment and anyone else that might disagree with you and your absurd absolutist assertions. You just blindly project the most extreme and rarest positions you’ve ever heard on all who disagree with you on any issue.

Priya Lynn

January 29th, 2016

I said in error to Enough already “Oh, this ought to be good. Please enlighten us as to what my “PC priorities” are”.

I should have said “Oh, this ought to be good. Please enlighten us as to what “my” “PC priorities” are.

enough already

January 30th, 2016

Gossar,
You raise a very interesting point. In the beginning, when there was a chance to fight the disease with the only type of condom which doesn’t feel absolutely horrid, the ‘lambskin’, scientists made a serious mistake in their statistical analysis and killed them off.
Of course I’d be overjoyed if a means were found to make condoms more appealing. I’d be equally happy if a way were found to make them more reliable.
We’re in agreement that a condom is better than nothing.
Where, I think, we differ, is due to our age difference or, perhaps, geography. I spent the worst part of the dying years in Berlin and San Francisco. Every appeal to use condoms was next to useless.
I just can’t express to you how absolutely worthless.
Anyway, I do appreciate that we can have a civil conversation.
Priya,
Why do you even bother? We all know how much you dislike me, we all know how far you’ll go out of your way to be disagreeable in disagreement with me.
Give it a rest. It doesn’t further your cause.

Gossar

January 30th, 2016

The difference between .99 and .80 for me is enormous.

That all depends on your cv and your dataset. Are you sure it’s normally distributed? What was your design and methodology? What power are you claiming?
;-) Don’t teach your grandson to suck balls.

Gossar

January 30th, 2016

Can we agree that HIV/AIDS probably won’t be the last disease to affect MSM as a group?

My concern is for the next plague as well as the current one.
“Winter is coming.”

Eric Payne

January 30th, 2016

Gossar asks:

Can we agree that HIV/AIDS probably won’t be the last disease to affect MSM as a group?

My concern is for the next plague as well as the current one.
“Winter is coming.”

You are 100% on the mark with that question, Gossar.

Even before HIV, there were members of the community (like Larry Kramer) who were warning of the health risks of an everyone-fucking-everyone-else closed community.

The result? Those people were publicly excoriated, derided and almost ostracized while the Fire Island orgies, the Meat Packing District hook-ups, the steam rooms and bathhouses kept turning a profit, and people who chose to remain ignorant were, unknowingly, killing themselves.

If there was one result of the AIDS pandemic besides death, it was to force the gay community to pivot it’s opinion on relationships. Now, a large portion of us choose to enter monogamous relationships… and, seriously, find me any gay man over 50 who believed, at the time they graduated high school back in the 1970s, they’d ever be able to legally marry another man (or even want to).

If that trend reverses itself, and the hedonism of the 1960s and 70s in which it seemed gay men used to revel reasserts itself, then “the next thing” is out there, already in its incubation period, just waiting.

Randy Shilts had a theory — and he touched upon it in Band — AIDS had been going on in Africa for quite some time, but because a person died from the opportunistic infections, and those were so varied, there was no correlation between the deaths; that it was the fateful, simultaneous mix of the American Bicentennial Celebration in NYC, International Fleet Week in NYC and the laissez-faire sexual attitudes of the 1970s (both gay and straight) that allowed the virus to break out of Africa, and that if it weren’t for a sudden mortality rate in a closed community such as ours, there never would have been a relationship made between these infections.

enough already

January 30th, 2016

Dear Gossar,
Busy today, so this will be very brief.
1) You have the stats. just like I do, we both know those two figures are pretty well established. Besides, the last time I got into one of those discussions here, some bright boy (who was wrong on that subject), fought me about where to set μ for several hundred words. How nice that we both are well educated.
2) I’m well aware that the next big horror is just waiting to attack. My home village in Germany has not, to this day, recovered the population we lost in the second wave of the black plague. The first one passed by fairly mildly, we still had cats. That era’s version of today’s conservative Christians had them all killed and the next wave, surprise, surprise came in together with a (also a big surprise) major loss of stored food-stuffs to vermin.
Who’d a thunk it?
We can’t even get teenage heterosexuals to stop having sex without contraceptives. You’ve zero chance of getting gay men to ‘go back’ to condoms, regardless of how absolutely wonderful, delightful, desirable, sex-enhancing and penis-enlarging we all know them to be.

Zero chance. The time and money would be better spent working on a new generation of antibiotics and Virostatika (antivirals? too early for English.)

Priya Lynn

January 30th, 2016

Enough already said “Why do you even bother?”.

Because you lie about me, saying things like I want to subjugate gay men. Why would you think that? Merely because I think people who aren’t in a monogamous relationship should use condoms?

You go on about my dislike for you but your hatred of me is apparent in the lies you tell about me.

Priya Lynn

January 30th, 2016

Enough already said “Why do you even bother?”.

And because you make absurd absolutist staments like “condoms are universally despised” and “condoms are an absolute failure”.

Stop lying about me and making absurd assertions and I won’t bother anymore.

enough already

January 30th, 2016

Dear Priya,
Let’s just get down to brass tacks, shall we?
The only gay men you get along with here are the ones who are tame and PC and willing to acknowledge your superiority.
I don’t.
I’m not tame, I reject PC, I reject right-speak=right-think and I refuse to let a heterosexual woman dictate my gayness.

Priya Lynn

January 30th, 2016

Enough, you have a delusional fantasy in your head that I’m somehow out to get you and gay men in general. The only thing I can think of that I’ve ever said that gives you that idea is that I encourage people not in a monogamous relationship to use condoms, I certainly in no way consider myself superior to gay men. I’ve been a longtime and fierce advocate for gay men and somehow you’ve blocked that out because you inexplicably want to see me as the enemy.

Please, let me set you straight, tell me in what way you think I want to subjugate gay men. Tell me what you think are “my” “PC priorities”. Because beyond me thinking people not in monogamous relationships should use condoms its clear you are imagining me in ways that bear no resemblance to who I am and who I’ve demonstrated myself to be on this blog.

I don’t care that you hate me for being pro-condom, what I do care about is you lying about me.

And by the way, I’m not heterosexual, I’m bisexual. Are you even aware that I’m a transexual woman?

Priya Lynn

January 30th, 2016

Enough, just please tell me why you think I see myself as superior to gay men, why you think I want to dictate your gayness?

enough already

January 30th, 2016

Priya,
I stand corrected. Bisexual is fine with me.
Of course I knew you were a transexual woman.
One of the few areas here upon which we agree is our strong defense of non-cis gendered people to be able have their anatomy fit their true gender.
We both have strong personalities (to put it mildly) and neither of us is good at giving a centimetre.

Priya Lynn

January 30th, 2016

Enough, if you’re going to assert that I see myself as superior to gay men, that I want to subjugate them, that I want to dictate their gayness to them it behooves you to either present evidence to back those claims up or to stop making them.

That’s what a good ethical person would do.

Priya Lynn

January 30th, 2016

So, the cat has EA’s tongue. It appears he doesn’t want to think too deeply about why he’s lying about me because he wants to keep doing it.

If you’re going to keep lying about me Enough Already then at least give me the courtesy of not pretending that its wrong for me to dislike you – my dislike of you is well justified by your insistence in lying about me.

If you were to treat anyone else the way you’ve treated me they’d be well justified in disliking you too.

enough already

January 30th, 2016

Priya,
There is nothing I can say which will change your approach to me.
I will grant you this – when Nathaniel went far too far in his PC double-plus good approach to those who dare to speak the truth, you defended me.
This, I appreciate.

Priya Lynn

January 31st, 2016

“There is nothing I can say which will change your approach to me.”.

Not true. Stop lying about me and making absurd absolutist statements like “Condoms are universally despised” and we’ll get along a lot better.

Priya Lynn

January 31st, 2016

What you think of me bears little resemblance to reality. I think all the abuse you suffered as a child has warped your view of the world and me.

enough already

February 1st, 2016

Priya,
I learned many years ago that the right-speak=right-think group will stop at nothing to enforce their double-plus good view on proper behavior for gay men upon us.
Look at the discussion gossar and I have had – his primary objection to my position is that telling the truth is not useful and productive. One should either be silent or pretend condoms are a joy and a delight.
You’re very much the same – you’ll fasten onto one tiny little corner of an argument and try to drag the whole thing down because, in the end, how dare a gay man voice an opinion contrary to the approved party-line.

Priya Lynn

February 1st, 2016

“Look at the discussion gossar and I have had – his primary objection to my position is that telling the truth is not useful and productive. One should either be silent or pretend condoms are a joy and a delight.”.

Please stop lying.

There is no “approved party line”. People who believe anyone not in a monogamous relationship should use condoms aren’t out to get you. No gay man is being oppressed by people who believe in safe sex.

I don’t care that you dislike condoms, what concerns me is your lying about me and lying about condoms being “universally despised” and “an absolute failure”.

You don’t speak for all gay men, stop pretending you do. If condoms were as unpopular as you claim they would have stopped making them decades ago. You are obviously wrong.

enough already

February 1st, 2016

I never claimed to speak for all gay men.
Doesn’t change the fact that you’re incredibly hostile when one dares to disagree with your PC positions.
As to your unceasing defense of condoms, facts are on my side. Virtually all men – except a few unusual ones posting here – hate the nasty things.
Sheesh.

Priya Lynn

February 2nd, 2016

Enough Already, There is nothing I can say which will change your approach to me.

enough already

February 2nd, 2016

Priya Lynn, There is nothing I can say which will change your approach to me.