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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 exp

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.
  - azinman2 7y ago
    Spreading fear? How about having an honest debate? Let's see.. so far in this thread I've been accused of being prejudice against gays (ad hominem), had goal posts moved repeatedly from my original post, accused of having no data and when presented it's rejected without sufficient reason provided, had my own personal experiences negated as if they don't happen and when acknowledged they're minimized, and now apparently I'm a fear monger. Amazing what happens when you point out vulnerabilities in public health with PReP! That's great for you that you're educated enough to perform rational risk analysis (assuming so given you're on HN) -- and you're willing to take the non-trivial semi-known long-term side effect trade offs. Plus you're honest with yourself about exactly what PReP is. However, that doesn't mean everyone follows. A diversity of education and logic-oriented thinking exists out there, yet sex is universal. I've personally heard individuals express that now that they're on PReP there's nothing to worry about so they can have condom-less sex worry-free, so I know this is non-zero. This is foolish. I think it's dishonest to not acknowledge the risks and vulnerabilities of a large population on PReP. Please look at a short history of epidemics [1] and tell me we're somehow magically done. Ebola was an example of something that once was contained now spreading again. Drug-resistant Neisseria gonorrhoeae is classified as an urgent threat by the CDC [2], and isn't shared by a handshake (to my knowledge). And that classification is from 2013. What will 2025 look like? 2045? Nothing about what I've said is saying we shouldn't have PReP. My original comment said it's made a big dent in the spread of HIV... hardly fear mongering. But it DOES make some portion of users feel safe to have condomless sex, and that creates new vectors that condoms were protecting against. Why is this so hard to acknowledge? [1] https://en.wikipedia.org/wiki/List_of_epidemics https://en.wikipedia.org/wiki/List_of_epidemics [2] https://www.cdc.gov/drugresistance/biggest-threats.html https://www.cdc.gov/drugresistance/biggest-threats.html

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.
- azinman2 7y ago
  Spreading fear? How about having an honest debate? Let's see.. so far in this thread I've been accused of being prejudice against gays (ad hominem), had goal posts moved repeatedly from my original post, accused of having no data and when presented it's rejected without sufficient reason provided, had my own personal experiences negated as if they don't happen and when acknowledged they're minimized, and now apparently I'm a fear monger. Amazing what happens when you point out vulnerabilities in public health with PReP! That's great for you that you're educated enough to perform rational risk analysis (assuming so given you're on HN) -- and you're willing to take the non-trivial semi-known long-term side effect trade offs. Plus you're honest with yourself about exactly what PReP is. However, that doesn't mean everyone follows. A diversity of education and logic-oriented thinking exists out there, yet sex is universal. I've personally heard individuals express that now that they're on PReP there's nothing to worry about so they can have condom-less sex worry-free, so I know this is non-zero. This is foolish. I think it's dishonest to not acknowledge the risks and vulnerabilities of a large population on PReP. Please look at a short history of epidemics [1] and tell me we're somehow magically done. Ebola was an example of something that once was contained now spreading again. Drug-resistant Neisseria gonorrhoeae is classified as an urgent threat by the CDC [2], and isn't shared by a handshake (to my knowledge). And that classification is from 2013. What will 2025 look like? 2045? Nothing about what I've said is saying we shouldn't have PReP. My original comment said it's made a big dent in the spread of HIV... hardly fear mongering. But it DOES make some portion of users feel safe to have condomless sex, and that creates new vectors that condoms were protecting against. Why is this so hard to acknowledge? [1] https://en.wikipedia.org/wiki/List_of_epidemics https://en.wikipedia.org/wiki/List_of_epidemics [2] https://www.cdc.gov/drugresistance/biggest-threats.html https://www.cdc.gov/drugresistance/biggest-threats.html