Adjusted PrEP plan

[BenjaminNicholas]

While you state that you might not be giving clinical advice, you are posting studies in an attempt to bolster your personal medication regime.  My problem isn't with what you do...  It's that other people might follow it thinking it's right for them.  

Bottom line, until Gilead does further studies supporting the use of intermittent PrEP, I am apt to go with their direction of one-pill-a-day.  

[Riobard]

8 minutes ago, BenjaminNicholas said:

While you state that you might not be giving clinical advice, you are posting studies in an attempt to bolster your personal medication regime.  My problem isn't with what you do...  It's that other people might follow it thinking it's right for them.  

Bottom line, until Gilead does further studies supporting the use of intermittent PrEP, I am apt to go with their direction of one-pill-a-day.  

R U kidding me, dude?!!! I never set out to post research. You are the one that gave me the challenge. And I thought it would be remiss to not correct some misinterpretations of data. 

Many in our tribe, judging by empowered behavioural choices I witness in customary brothels, should indeed consume 24/365. 

I see what the problem is here, Benji ... you want the last word. Have at it. Be the dog vehemently overworking the bone. No lightning rod of yours, frankly, is going to attract an epiphany let alone a bit of give in your stance. 

Gilead actually does not manufacture my tenofovir-emtricitabine regime. In any case, manufacturers sponsor, not do, research. 

Caeron, kkkkkkkk, right? LMAO.

[mvan1]

1 hour ago, Riobard said:

R U kidding me, dude?!!! I never set out to post research. You are the one that gave me the challenge. And I thought it would be remiss to not correct some misinterpretations of data. 

Many in our tribe, judging by empowered behavioural choices I witness in customary brothels, should indeed consume 24/365. 

I see what the problem is here, Benji ... you want the last word. Have at it. Be the dog vehemently overworking the bone. No lightning rod of yours, frankly, is going to attract an epiphany let alone a bit of give in your stance. 

Gilead actually does not manufacture my tenofovir-emtricitabine regime. In any case, manufacturers sponsor, not do, research. 

Caeron, kkkkkkkk, right? LMAO.

4

Job well done - 

[RA1]

Everyone needs to seek and follow advice particular to their own problem.  It seems that gratuitous advice is seldom well received.  Caveat Emptor.

 

Best regards,

RA 

[TotallyOz]

I didn't see this thread start out as advice. I saw it as someone doing something different than I had seen and I asked questions and clarification. Having read on my own, I did not know there were alternatives to the daily dose.  Now, I know that is an option. I appreciate the OP broaching this subject and sharing his insight.  Everyone should read their own research and do their own due diligence. Talking to friends outside of the USA and even to my doctor in Bangkok who is a specialist, he did give credence to those that take it in short cycles as opposed to daily. In the end, everyone has to decide how best to lower their own risk vs the risk of harm done. I have made a decision for myself as I have worried for a while about the long term side effects to daily doses of any medication and effects on my body. Feel free to keep debating but I appreciate the OP information about something I have never known was an option.

[AdamSmith]

11 hours ago, Riobard said:

It would be, but you have grossly misinterpreted Ipergay. You need to read beyond the brief summary abstract.

On demand Truvada 1% infection annually; 99% effective, not 86% effective. Placebo, no drug, 7% annual infection. All considered, fucking without any Truvada, 93% safe. Remember, HIV is a wimpy retrovirus until you get one particle germinating in your bloodstream.

A 14% failure rate might occur in a study arm of full--time darkroom ass-in-sling non-HAART-consuming bttms. For low infection rates, 86% more effective is impressive. Do not get caught up in the complex stats math ... things like rigourous confidence intervals override simple arithmetic and are extreme in taking our wellbeing seriously. 

Thank you for this background.

Yoir pointing out that chi-square etc techniques need to be applied to accurately process these raw results is vastly helpful to qualify & quantify these data.

[AdamSmith]

Every experimental data set has to be rigously pushed through a bunch of quantitative tests to see if it in fact means anything at all.

[Riobard]

Yes, and Ipergay was dumped in favour of moving to comparing the two methods also (I neglected to add) due to the imperative of dispensing the on demand regimen to the placebo group that was demonstrating such a higher rate of breakthrough transmission. Current ongoing comparison of the two drug uptake methods poses less ethical conundrum because all get the meds. What I have not had time to explore is whether subjects self-select method based on preference and sex patterns vs randomized, matched for sex patterns plus randomized, etc. I would guess it is the former.

The media sometimes abridges the details, as do conference abstracts, and google is a great but sometimes overwhelming friend. I also opened up Fugues (March edition) in Montreal and saw drug ads for poz I had not heard of. Perhaps PrEP will also evolve to new components down the line. Such a huge gap from single-item AZT menu, right? 

Stay safe, all!

[Riobard]

10 hours ago, AdamSmith said:

Thank you for this background.

Yoir pointing out that chi-square etc techniques need to be applied to accurately process these raw results is vastly helpful to qualify & quantify these data.

Good for you, dude! 4 quadrants: Group 1 neg Time 1, G1 poz T2, G2 neg T1, G2 poz T2. 

[Riobard]

On 2/25/2019 at 1:11 AM, tassojunior said:

Kaiser gave me a prescription for Prep but it was $1000. Has anyone tried the Indian mail-order stuff? Hopefully Kaiser would still monitor me .

Oh, geez, tassojr, this is so tricky!!! I don't know what to say. Maybe contact Gay Men's Health Crisis NYC or the ASO in your city, or Ryan White Fdn. The Gilead patent is up and I am taking a considerably cheaper generic version in Canada. Tevapharm's emtricitabine/tenofovir. The company may have geared to income compassionate release. I would just suck up the cost for now. 

[TotallyOz]

https://www.pulse-clinic.com/prep/

Interesting that many clinics are also saying the PrEP can be used for shorter, medium or longer periods of time depending on sexual activity.

[TotallyOz]

On 2/26/2019 at 11:36 PM, BenjaminNicholas said:

While you state that you might not be giving clinical advice, you are posting studies in an attempt to bolster your personal medication regime.  My problem isn't with what you do...  It's that other people might follow it thinking it's right for them.  

Bottom line, until Gilead does further studies supporting the use of intermittent PrEP, I am apt to go with their direction of one-pill-a-day.  

This may also have to do with the level of sexual activity. I know guys that do not have sex except when they travel and thus for the majority of the year they have no need to take PrEP. But, I do think it is an individual decision based on planned activity. 

[TotallyOz]

On 5/12/2019 at 6:53 PM, TotallyOz said:

This may also have to do with the level of sexual activity. I know guys that do not have sex except when they travel and thus for the majority of the year they have no need to take PrEP. But, I do think it is an individual decision based on planned activity. 

I also spoke to my doctor who suggested that this could be better on the body to take when someone is only sexually active for periods of time to take before, during and after those periods but not all year long.