PrEP Use in Brazil and Condomless in the Saunas

[Canadianbtmguy]

I hope this is not a taboo subject. This year we celebrate the 10th anniversary of FDA approval of PrEP. (Yes, indeed, I know that PrEP does not protect against other STIs). One of the initial study sites that led to the FDA approval of PrEP was in Brazil and in my pre-covid trips I found that a sizable minority of free Grindr Brazilian guys were into condomless. (In some cities in my travels such as SF, Miami, London, Amsterdam and maybe Paris, condomless seems the majority position.) I have had a few condomless experiences in the saunas, and one with a garotocomlocal, but it seems substantially less than the free gay Grindr Cariocas. I'm speculating that PrEP is tagged as "gay" and straight/bi identifying garotos don'gt want to take it? Or do they take it but still use condoms?

[Riobard]

The challenge is differentiating effects among the variables of orientation, transactional sex for any of these, and regularity of condom use.

This article below reveals that uptake among eligible gay-identified men remains very low in spite of free access the past 5 years. I wrote a bit about it here a few years ago as well. Transactional sex as a factor among gay men does not influence the odds of taking PrEP. Their HIV knowledge increases the odds while degree of internalized homonegativity decreases the odds. 

Your questions are essentially all over the map (not your bad) because the cartography is so complex. Just what is it you want to know more about?

So let’s turn to one subgroup that you referred to and represents the majority of my experiences, straight-identified garotos de programa, mainly in brothels, with whom I engage in transactional sex. I don’t inquire about their HIV status. I don’t ask what medications or gym supplements they consume. I assume they have at least one current or continuous STI on board, general unverifiable rule of thumb. To access PrEP they must go to a dispensing centre and declare belonging to either the MSM or transactional sex category. The latter may be ambiguous as it could connote being a provider to females, but stepping up to the PrEP access is basically self-stigmatizing for many. It would be hard to assess patterns among male commercial sex workers as a whole or stratified by orientation. 

I find that condom use is the default they impute to me for receptive anal intercourse. If they offer their ass, the assumption is insertive intercourse would be reciprocated with condom use. They either automatically obtain condoms that are charged to my tab or I pre-empt the charge by producing my own. I don’t ask whether there is scope to not use condoms because that would be superfluous information predicated on mere curiosity unless they happen to offer the option on request; I simply live with not knowing and I don’t ask other punters either. A declaration from the escort that he consistently uses condoms would not influence my own use. I assume that, to their way of thinking, my asking them if they fuck guys condomlessly would simply mean I may want that too. They are generally oriented to getting down to business, not engaging in a dialogue related to sexual practices … unless the constituent elements relate to a potential upcharge. So this has all been worked out ahead of time according to my preferences and standards, and I don’t waste time on the ground imploring for particular privileges. 

Now you may get somebody piping in that all their sexual contacts are extremely knowledgeable and on PrEP … ergo all the hooboys are taking it. Wrong. 

https://pdf.sciencedirectassets.com/779101/1-s2.0-S2667193X21X00075/1-s2.0-S2667193X21001484/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjECwaCXVzLWVhc3QtMSJIMEYCIQCKHN2EpO1bGlaSU2CGbq9xW5YWipB%2F0Ul09c2vCegWygIhAPqJbSIFZUIu0U1jTRPLbIYorLGTupKPnGox3fx1qvspKtIECBQQBBoMMDU5MDAzNTQ2ODY1Igwdn4seqtTu7nRwXAEqrwQqIaq0lNhXAUEbx8cwp5I5aHn13wTeQe0qu4IbKeB87LUDfHzjvULREuRX01xinFId0xjcI83tLfVovFv1tWIWzdoJzLxJvL1rQy%2B0v7pwnQQEYPa4hLhCexQFD8Mc3ft2F8R%2BYy4UWX1wAAltAE06ipqNEFq2cjeuP03aMbXOtnAt%2Fv4jxv%2BHYnBqri7no%2FqoCmx562u33KTi%2F0kBM8jmUYonFlowxtfDnda2T61LiHRoaUhaUKASsahnXaVTyps99GtdELwHU6aX88%2FVqyzL2JWnFZUeJPZXSBf8nV6VYY19swX8zojwZI6VRnY94GxRMWRc6Kp6xgfeuypHjmrMfRZdGUU55GaRORwymxswNVjGMyE6WHORtkLlsake33RV4fidnuUXwCeJWTo5efONivhbDRhF9EfcOVDGeY0P8Mmohos1GT6%2BMc4Z%2Fi1V9TY%2BbiRxqtzmJK5JstP5k2z%2B6YsOpxmWwOi4Z6%2F2pcWPP66WQhxuOvpQmiAClnb2Aja9vHdd2%2B4PZyNxIz0eADpnC3mI1Dnp8FvJn35V%2FIzFeUzlvgH1SjAioSLqCCo7x50ryyyiFYRsRONZuu6QYUsU5EJSDxRATf4NU22%2F5pYRZUyKiqyBbgCPfwx8Fi5pVgUj4kIH3c9BbZ%2FvdcYjyo35yObRR7qfSu28UBRJvdsgzmTdgSO1bwXCGWqqFS3EcNDC2z2k9SZlRsvpqG4pMdQcwJpkDBZfb30G3GRydL8mMNLtnZQGOqgBFLnk8F5LrbyBf6jHFCZmVCwktU%2FGDDCcF6Yr9JNEKcp7snsuwwW4DWQDc19ZFau4vfuCoAQ%2BU%2Ff3Bt0ni3RgfQ8i4F4Zib1GU01euYQ2yg%2FsQkvGz%2Bh%2FUX1QOwE57Dc75IomL9Jif8RhUZa7Y%2Fyk9DnB4k0u3yrNPLcKx%2FAfWv%2FB6ufxHDujnV6Moh%2BFsg%2BeVlcpoIakWqEdN2tFkC64fPlhm8Hk8v0g&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20220520T121827Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTY5ALRUNGD%2F20220520%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=7c1309b92817fa1231f5e4623a539929e8ae8c40c39bcc150382a0394b17d5a0&hash=9e34e6bdad80012466d2e98c3ad6d881e13e1a9ab911f5c63830343adcf6876b&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S2667193X21001484&tid=spdf-7edec2ca-a2d3-465b-bab2-a5e1a466e75f&sid=5b2bdea79a06d14ae28ac712c53bbbac78dagxrqa&type=client&download=true&ua=4d55015350540400555c&rr=70e503db489e8c6b

[Novarunner]

I also don’t inquire about PrEP use when in a sauna.  The guys I have met in Brazil on Instagram or Grindr or at the beach or exchanged WhatsApp with and reconvened with outside the sauna…. I would say about 90% are on PrEP.  That’s just my personal experience though.

One 19 year old I met on Grindr last trip had been on PrEP for as long as he had been sexually active.  He made a joke about only having ever worn a condom the handful of times that he had had sex with women.  He was very well educated and from a well off family though so certainly an atypical example.  The comment did make me feel old though.  Very, very old.

[Guest]

On 5/20/2022 at 3:32 AM, Canadianbtmguy said:

I hope this is not a taboo subject.

bareback sex is not a taboo subject - but has been a frequent favorite topic of conversation/inquiry by trolls in this forum.  bordering on obsession.

i think it’s fair to say that nobody likes condoms & they aren’t sexy or fun.  

just my opinion, but going into a rentboy sauna & expecting bareback sex is insane.  Prep or not.  And, do you really expect an unknown person to tell you the truth about being on Prep anyway ?? Taking the word of a stranger for a decision that can directly affect your health ? And if they’re gonna fuck you without a condom, then he’s fucking lots of others without condoms too.

many guys in developing countries have access to prep - but they may not have access to a full array of STI testing & treatment.  And, STIs mutate & develop ways around traditional treatment.  In the last 2 years, the US CDC has changed the course of treatment for chlamydia &gonorhea because it’s now a more robust infection - harder to get rid of it. 

I know - condomless/barebacking is routine in the US now, especially on the apps.  And I think it’s nuts.

[Canadianbtmguy]

I do think that some people do like condoms...perhaps they have been using them for so long that they are linked with sex. Others of an older generation may credit them with saving their lives while their peers succommed and are loathe to give them up.

I totally respect guys who do PrEP + condoms, the safest alternative, but I do have something of an issue with guys who do not take PrEP, only use condoms and call PrEP-protected but condomless sex unsafe. (I'm not suggesting the previous poster is doing this; I detect it a lot on Grindr among middle-aged guys in Europe) That is flouting the science.

For me, PrEP has been a liberation, both from the fear that was still present with the condoms (breaking or was the top taking it off in doggy...) and also from the unwelcome  "barrier" to the connection between me and the guy. San Francisco buses once had promotion for PrEP heralding it as "OUR Sexual Revolution" and I heartily agreed. It really suggests that gays too deserve the condomless sex that was the result of the original sexual revolution.

I will admit that the preference is mostly psychological...does it really "feel" that different when the top wears one?....but it is a strong preference indeed. All the more so if I'm going to buy a piece of meat, I really don't want to take it wrapped in plastic.  I will....if the guy is otherwise hot enough, but I will take an otherwise a (slightly to somewhat) less hot guy who will go condomless.

I take PrEP and so I am not reliant on the veracity of the garoto whether he takes it or not. The only issue where I am a bit concerned is sometimes on a borderline guy (a guy I'm not into enough if he wants to use condoms), when I ask him if he will do condomless, he says no and I decline, hopefully the incentive for the future would be to take PrEP, but I have some qualm that they could be incentivized to agree to condomless without the step of taking PrEP, which while I do take PrEP they could end up in the future incentivized to go condomless with a client who may not be

[Guest]

13 hours ago, Canadianbtmguy said:

do think that some people do like condoms

No - just stop. Nobody likes them.  Seriously ?

[maump]

A little off topic.  I was in Colombia Medellin and Bogota.  Most rentmen did not seem to know about prep; and the few that did said it was too expensive to get it. No one I chatted with had ever said they were tested.  All seemed to think they would not get it.  Only 2 or 3 out of 15 said anything about a condom when we had sex.  The bottoms were comfortable with me breeding them.  The real professionals just ask for more money for Bareback.  No free man hookup wanted a condom, top or bottom.

I went tested clean to Colombia on prep and antibiotic prophylactic.  I will get tested Thursday for my post visit.