PrEParations

[Radek48]

On 24.10.2022 at 20:17, 18past19 said:

Ponieważ nie ma narażenia na ryzyko, nie biorę prep w domu. 

Podczas mojej ostatniej wizyty w LOS skończyłem na PEP. Można to uznać za minimalne ryzyko, ale dla świętego spokoju zdecydowałem się je podjąć.

Aby uniknąć podobnego błędu, tym razem zdecydowałem się na PrEP i zacząłem go brać. zaleca się rozpoczęcie na dwa tygodnie przed spodziewanym ryzykiem.  

Istnieje również PrEP „na żądanie”, jeśli nie chcesz codziennego PrEP. Zwykle nazywa się to harmonogramem 2-1-1. skuteczność nie jest tak dobra, jak przy codziennym preparacie i nie jest zatwierdzona przez amerykańską FDA. ale jest szeroko stosowany. 

For anal contacts, 7 days is enough

[maump]

On 10/24/2022 at 7:28 PM, Shonen said:

You think probiotics might help? I’ve taken many antibiotics over the years in Thailand and regret not taking the probiotics till now. In theory it makes sense to replace lost bacteria with healthy kind. The brand I took with me has like 40 billion bacteria or whatever the critters are in it. Don’t understand how they all fit.

you do know that there are  more bacteria living in you than there are cells of your body.......  40 million is nothing.....

The researchers calculated the number of bacteria in the large intestine to be 3.9x10¹³. All other organs of the human body contain at most another 10¹² bacteria. This means that in total, some 3.9x10¹³ (39 trillion) bacteria frolic in and on the human body .

[maump]

On 10/24/2022 at 12:23 PM, floridarob said:

I'm a believer that frequent antibiotic use isn't good for the body. Antibiotic resistance and hurting the microbiome and the ecosystem of healthy bacteria in the gut.......most of the times, my results have been negative when I thought perhaps otherwise.

I agree, but I think using them in this circumstance is prudent.... especially if you like to eat street food (or boy ass) and bareback fuck.   greatly reduces changes of syphilis, gonorrhea, Chlamydia and travelers diarrhea.  doxycycline is routinely prescribed long term for acne in USA....

[maump]

On 11/6/2022 at 11:25 AM, Novarunner said:

Let’s say, hypothetically of course, that an American citizens was planning to spend 6 months in RJ next year and that this particular American citizen takes PrEP which is prescribed to him by his doctor in 90 day increments so the Rx will need to be refilled at least once but probably twice during the 6 month stay.

Minhas perguntas para vocês:

1. The gorgeous 25 year old that this American citizen will be be spending most of his time with says he gets his Rx for free by going to a public health clinic in RJ and telling the doctors there that he has sex with other men.  Gorgeous-25-year-old sees no reason why non-gorgeous-40-year-old-American can’t just come with him and also get free PrEP too from the clinic.

Could one of the esteemed members of the board confirm that Brazil will not actually in fact give PrEP - which is a rather expensive drug - to an American in the country on a tourist visa for free?

2. Is planning a mid-stay return trip to the States probably the best way to go about getting the Rx refilled?  Other factors will probably make at least one return trip necessary anyway so this is definitely an option too.

the current price of generic truvada (PrEP) in USA at costplusdrugs.com is 45$ for 90 day supply, you can easily get a double set of drugs for travelling (although it may be illegal to bring that much drug into the country you are going to.)

tadalafila (cialis) 20 mg  90 for 13$.  similar for viagra.

[GWMinUS]

• It's best not to drink alcohol while taking doxycycline because it can stop it working properly.

[floridarob]

I'm glad tetracycline antibiotics exist, but hesitant to use them. Long term use, the bacteria can become resistant.

My GP (internal medicine specialty) was very concerned when he heard my Derm Dr recommended  taking this, he asked me to think twice, said it's VERY hard on the good bacteria that we need. He felt better me using topical cream as a substitute.

 

Take an antibiotic for the shortest time possible

When including an antibiotic in your acne treatment plan, your dermatologist will prescribe it for the shortest time possible. Because acne takes time to treat, this usually means three to four months.

[Mavica]

On 11/4/2022 at 8:40 PM, Phoenixblue said:

Taking antibiotics without a bacterial infection ain't a good idea, just destroys your gut microbiome. Unless there's a real threat to one's health. Even so stack up on natural probiotics and eat healthy food; Good luck

My personal experience has been that my physician(s) in the USA have substantially reduced the number of times they prescribe antibiotics.  Mexico, where I've lived/worked and continued to travel ... where antibiotics were once dispensed without a prescription ... now require a prescription to obtain.  I think there are many countries where access to antibiotics has been restricted.

[nikba2515]

On 1/14/2023 at 11:39 AM, spoon said:

Then i still fail to understand. Normal PreP is for HIV, doxy has little to no protection against that. Also, Prep has zero pretection against any bacterial STI. So i cant understand your reasoning.

Strong doses of Antibiotic helps to protect against disease related to unprotected sex and taking it immediately after an incident, according to my doctor. 

[spoon]

24 minutes ago, nikba2515 said:

Strong doses of Antibiotic helps to protect against disease related to unprotected sex and taking it immediately after an incident, according to my doctor. 

For bacterial STI, yes... But HIV is viral, so u need antiviral. For HIV, post exposure is PEP. 

[maump]

On 1/15/2023 at 1:31 PM, GWMinUS said:

• It's best not to drink alcohol while taking doxycycline because it can stop it working properly.

there appears to be a lot of conflicting info on this issue.   

The search was conducted from inception of each database to 2018 using PubMed, Medline via Ovid, and Embase. It included studies that involved interactions, effects on efficacy, and toxicity/adverse drug reactions (ADR) due to concomitant alcohol consumption and antimicrobials. All interactions were considered in terms of three components: (i) alteration in pharmacokinetics/pharmacodynamics (PK/PD) of antimicrobials and/or alcohol, (ii) change in antimicrobial efficacy, and (iii) development of toxicity/ADR. Available data support that oral penicillins, cefdinir, cefpodoxime, fluoroquinolones, azithromycin, tetracycline, nitrofurantoin, secnidazole, tinidazole, and fluconazole can be safely used with concomitant alcohol consumption. Data are equivocal for trimethoprim-sulfamethoxazole. Erythromycin may have reduced efficacy with alcohol consumption, and doxycycline may have reduced efficacy in chronic alcoholism. Alcohol low in tyramine may be consumed with oxazolidinones. The disulfiram-like reaction, though classically associated with metronidazole, occurs with uncertain frequency and with varied severity. Cephalosporins with a methylthiotetrazole (MTT) side chain or a methylthiodioxotriazine (MTDT) ring, ketoconazole, and griseofulvin have an increased risk of a disulfiram-like reaction. Alcohol and antimicrobial interactions are often lacking evidence. This review questions common beliefs due to poor, often conflicting data and identifies important knowledge gaps.

[vinapu]

27 minutes ago, maump said:

oral penicillins, cefdinir, cefpodoxime, fluoroquinolones, azithromycin, tetracycline, nitrofurantoin, secnidazole, tinidazole, and fluconazole

sounds like 12 lost tribes of Israel

[thaiophilus]

9 hours ago, maump said:

The disulfiram-like reaction, though classically associated with metronidazole, occurs with uncertain frequency and with varied severity. Cephalosporins with a methylthiotetrazole (MTT) side chain or a methylthiodioxotriazine (MTDT) ring, ketoconazole, and griseofulvin have an increased risk of a disulfiram-like reaction.

Yes, don't mix alcohol with metronidazole (aka Flagyl). Not because it makes the antibiotic ineffective but...

... the "disulfiram-like reaction" consists of nausea, vomiting, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and general hangover-like symptoms among others. (Disulfiram is better known as Antabuse.)

[vinapu]

3 hours ago, thaiophilus said:

Yes, don't mix alcohol with metronidazole (aka Flagyl). Not because it makes the antibiotic ineffective but...

... the "disulfiram-like reaction" consists of nausea, vomiting, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and general hangover-like symptoms among others. (Disulfiram is better known as Antabuse.)

right , drinking Hong Thong is much cheaper if somebody needs hangover like symptoms

[thaiophilus]

5 hours ago, thaiophilus said:

Yes, don't mix alcohol with metronidazole (aka Flagyl). Not because it makes the antibiotic ineffective but...

... the "disulfiram-like reaction" consists of nausea, vomiting, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and general hangover-like symptoms among others. (Disulfiram is better known as Antabuse.)

perhaps I should add that the above is from Wikipedia, not personal experience 😀

[maump]

15 hours ago, thaiophilus said:

perhaps I should add that the above is from Wikipedia, not personal experience 😀

I was quoting the summary of a medical study which concluded warnings are inconsistent, often generic and based on little actual study.

but doxycycline is probably ok with alcohol....  and I certainly have been drinking a lot this trip.....

[vinapu]

5 hours ago, maump said:

and I certainly have been drinking a lot this trip.....

I like people not wasting vacation time 

[KeepItReal]

I am very pro-sex workers and pro-science. The problem is that both of those things are often misunderstood (sometimes intentionally). Of particular concern when it comes to both is the new trend of doxy pep / casual use of anti-biotics - especially when I read articles like this. 

https://arstechnica.com/science/2024/03/super-gonorrhea-rate-quickly-triples-in-china-now-40x-higher-than-us/

[spoon]

On 3/31/2024 at 8:26 PM, KeepItReal said:

I am very pro-sex workers and pro-science. The problem is that both of those things are often misunderstood (sometimes intentionally). Of particular concern when it comes to both is the new trend of doxy pep / casual use of anti-biotics - especially when I read articles like this. 

https://arstechnica.com/science/2024/03/super-gonorrhea-rate-quickly-triples-in-china-now-40x-higher-than-us/

Similar concerned was raised by my doctor when i asked about doxy-prep. He is against it, especially when it comes to public health issues like antibiotic resistance issue. He went on explaining that within the health ministry, there is a very strict guide on prescribing antibiotics for certain diseases, to ensure risk of developing and spreading of antibiotic resistance strain to be kept at minimum. The way i understands it, they will switch the use of different kind of antibiotic for certain period of times for similar diseases, especially with regards to stds. 

[Olddaddy]

I just went to my GP here in farangland , he tells me to start Prep 2 days before sex .

So no need to take it everyday 

[roughjock]

On 4/2/2024 at 12:50 PM, Olddaddy said:

I just went to my GP here in farangland , he tells me to start Prep 2 days before sex .

So no need to take it everyday 

Really? I was advised 7 days before sex for daily dosage. Although I believe you can take 2-1-1 dose (4 pills in 3 days) and it provides some protection if you have infrequent sexual encounters. 

[Keithambrose]

15 minutes ago, roughjock said:

Really? I was advised 7 days before sex for daily dosage. Although I believe you can take 2-1-1 dose (4 pills in 3 days) and it provides some protection if you have infrequent sexual encounters. 

Yes, most advice is 2 pills on the day you have sex, plus one for 2 days after. 

[Riobard]

It’s a question of lead-in dosing, depending on what is predictable and practical, for sufficient mucosal drug concentrations. On-demand or event-driven method 2-1-1 (and then daily ongoing or repeat 2-1-1 depending on activity break durations) with the double dose 2-24 hours before first sexual encounter will provide initial protective drug concentration. Alternatively, a week of daily single dose while celibate with respect to risk: essentially [1-1-1-1-1-1-1] - 1-1 … 

I have greater hesitancy for the on-demand method until a few days of the single dosing are done and dusted, but use condoms for anal anyway. 

The pharmacology investigators of drug concentrations based on 4 doses weekly (not to be conflated with 2-1-1) nevertheless consider daily dosing to be a more robust recommendation as that regimen has more routinization and affords drug concentrations expected to persist in the protective range in the event of missed doses. 

[18past19]

what a coincidence! some replies here alerted me while i just landed on the LOS again. i am glad i didnt have to take any more new vaccines prior to this trip. but yes i have started my descovy a few days prior. let’s see what Songkron has to offer this time. 

[vinapu]

28 minutes ago, 18past19 said:

what a coincidence! some replies here alerted me while i just landed on the LOS again. i am glad i didnt have to take any more new vaccines prior to this trip. but yes i have started my descovy a few days prior. let’s see what Songkron has to offer this time. 

welcome in Bangkok, have fun and don't forget to report. But yes , fun first and second