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Please—and I can't stress this enough—do not make up lies about this kind of thing. It's dangerous. There is currently no evidence that PrEP "lulls many into a

Please—and I can't stress this enough—do not make up lies about this kind of thing. It's dangerous. There is currently no evidence that PrEP "lulls many into a false sense of security". It's possible that the existence of a method that can effectively eliminate the risk of HIV transmission could cause a change in behaviour which exposes people to other, different risks. It is entirely far from clear that this is the case, or that if it were, then that there would still not be a net public health benefit. PrEP is, FWIW, quite possibly more effective at HIV prevention than condom use is. It would plainly be ridiculous to be worried about the existence of condoms, because they were likely to "implicitly bless dangerous behaviour", and we have plenty of evidence that abstinence campaigns pushing this message are absolute failures.

azinman2 7y ago
I cannot disagree with you enough. I know from personal experience and that of my friends that frequently strangers are pressuring people into condomless sex strictly BECAUSE of PReP. And if you question it you’re told that you’re ignorant. The reality is no one wants to wear a condom, but they only do if they feel the need to. PReP removes this barrier for many because they feel that they’re still safe without one. I don’t have data I can point to, but between personal experience and at least a good understanding of the (coastal US) gay community, I have no qualms stating this is the case. Again — I already said PReP was highly effective as a public health tool against HIV, but in doing so, we leave the door open to many new kinds of viruses that it doesn’t protect against given the lack of condom usage. Update: It’s not to hard to find data that verifies my personal experience: https://www.ncbi.nlm.nih.gov/m/pubmed/29509889/ https://www.ncbi.nlm.nih.gov/m/pubmed/29509889/
- gugagore 7y ago
  The problem is that you're spreading more fear around gay sex. Of course there's a higher risk of transmission of disease without a condom. It's not been my experience that anyone says, with a straight face, that you're ignorant if you want to use a condom in spite of PrEP. But what is ignorant is to decide where other people's risk thresholds should be. You're right that no one wants to wear a condom. It's not a false sense of security to have condomless sex because of PrEP. It's real sense of security. People feel safer, and they are safer from HIV. People are afraid of dying, and no one enjoys thinking about catching a death sentence when they have sex, especially sex that's been (and is) strongly stigmatized. If personally, you decide that extra security isn't enough, that is a great decision. If you want to think about the future, and the risk of catching a resistant strain of a bacterial infection, or some yet-understood (new kinds of) viral infection, that is totally okay! But I don't think it's okay for you to say everyone should think the same way. It's hard to measure the "risk" of the anxiety caused by gay sex.
  - azinman2 7y ago
    First, I’m glad that has been your experience. It hasn’t been mine, including friends who have been pressured into condomless sex. Being told you’re ignorant is a common tactic amongst the stories I’ve heard and texts I’ve been shown. I’m not spreading fear. I’m looking at this history of viral epidemics and saying it’s foolish to think that now that we have PReP there’s no other way to die from sex. Does PReP stop Ebola? Or even bacterial infections that are antibiotic-resistent? HIV in humans is only decades old. That’s nothing in the timeline of humanity. At some point in the future another terrible STD will come along. The history of viral mutations guarantees it. And PReP won’t be able to stop it, condoms might, but those on PReP will be vulnerable. Again, is PReP making a big dent in the spread of HIV? Yes. Is it allowing some to feel ok about not using a condom where as they would have before? Absolutely. It’s “net positive” (no pun intended) for now... until the next scarier virus comes along...
    - gugagore 7y ago
      "until the next scarier virus comes along..." is the part I call "spreading fear". If you want to worry about Ebola, and use condoms because of a possible risk of contracting Ebola, I would say you have set your risk threshold at a place more conservative / risk-averse than pretty much every sexual adult, at least in my part of the world. Every interaction with another organism, whether it's a handshake or sharing the same air, carries the risk of transmitting something terrible and scary. And there are people who think about that, and probably have different standards for sharing drinks, or double dipping, or handshaking strangers, or whatever. Other people do not care. They will hug someone who has the flu. It's a personal call. When someone has sex without a condom and takes PrEP, I argue they are not thinking "Oh good, there's no possible way I'm going to die." They are not even thinking "I will not get any STIs". They are thinking "Oh, good, I don't have to think about dying from HIV". That's not foolish. Your characterization is unrealistic and equivocates risk-taking with foolishness. You imply (say) that people are ignorant of the risks, as opposed to taking a deliberate risk. And I would be more careful before saying something so offensive and disrespectful. That's where I set _my_ risk threshold, at least.
      - 7y ago

azinman2 7y ago

I cannot disagree with you enough. I know from personal experience and that of my friends that frequently strangers are pressuring people into condomless sex strictly BECAUSE of PReP. And if you question it you’re told that you’re ignorant. The reality is no one wants to wear a condom, but they only do if they feel the need to. PReP removes this barrier for many because they feel that they’re still safe without one. I don’t have data I can point to, but between personal experience and at least a good understanding of the (coastal US) gay community, I have no qualms stating this is the case. Again — I already said PReP was highly effective as a public health tool against HIV, but in doing so, we leave the door open to many new kinds of viruses that it doesn’t protect against given the lack of condom usage. Update: It’s not to hard to find data that verifies my personal experience: https://www.ncbi.nlm.nih.gov/m/pubmed/29509889/ https://www.ncbi.nlm.nih.gov/m/pubmed/29509889/

gugagore 7y ago
The problem is that you're spreading more fear around gay sex. Of course there's a higher risk of transmission of disease without a condom. It's not been my experience that anyone says, with a straight face, that you're ignorant if you want to use a condom in spite of PrEP. But what is ignorant is to decide where other people's risk thresholds should be. You're right that no one wants to wear a condom. It's not a false sense of security to have condomless sex because of PrEP. It's real sense of security. People feel safer, and they are safer from HIV. People are afraid of dying, and no one enjoys thinking about catching a death sentence when they have sex, especially sex that's been (and is) strongly stigmatized. If personally, you decide that extra security isn't enough, that is a great decision. If you want to think about the future, and the risk of catching a resistant strain of a bacterial infection, or some yet-understood (new kinds of) viral infection, that is totally okay! But I don't think it's okay for you to say everyone should think the same way. It's hard to measure the "risk" of the anxiety caused by gay sex.
- azinman2 7y ago
  First, I’m glad that has been your experience. It hasn’t been mine, including friends who have been pressured into condomless sex. Being told you’re ignorant is a common tactic amongst the stories I’ve heard and texts I’ve been shown. I’m not spreading fear. I’m looking at this history of viral epidemics and saying it’s foolish to think that now that we have PReP there’s no other way to die from sex. Does PReP stop Ebola? Or even bacterial infections that are antibiotic-resistent? HIV in humans is only decades old. That’s nothing in the timeline of humanity. At some point in the future another terrible STD will come along. The history of viral mutations guarantees it. And PReP won’t be able to stop it, condoms might, but those on PReP will be vulnerable. Again, is PReP making a big dent in the spread of HIV? Yes. Is it allowing some to feel ok about not using a condom where as they would have before? Absolutely. It’s “net positive” (no pun intended) for now... until the next scarier virus comes along...
  - gugagore 7y ago
    "until the next scarier virus comes along..." is the part I call "spreading fear". If you want to worry about Ebola, and use condoms because of a possible risk of contracting Ebola, I would say you have set your risk threshold at a place more conservative / risk-averse than pretty much every sexual adult, at least in my part of the world. Every interaction with another organism, whether it's a handshake or sharing the same air, carries the risk of transmitting something terrible and scary. And there are people who think about that, and probably have different standards for sharing drinks, or double dipping, or handshaking strangers, or whatever. Other people do not care. They will hug someone who has the flu. It's a personal call. When someone has sex without a condom and takes PrEP, I argue they are not thinking "Oh good, there's no possible way I'm going to die." They are not even thinking "I will not get any STIs". They are thinking "Oh, good, I don't have to think about dying from HIV". That's not foolish. Your characterization is unrealistic and equivocates risk-taking with foolishness. You imply (say) that people are ignorant of the risks, as opposed to taking a deliberate risk. And I would be more careful before saying something so offensive and disrespectful. That's where I set _my_ risk threshold, at least.
    - 7y ago