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    BigPlopsRich Juzwiak
    3/04/14 1:08pm

    Uggh...it irritates me so much that you talk about this here. This is not the audience and this is not going to educate anyone.

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      Johnny ChundersBigPlops
      3/04/14 1:11pm

      ?

      I was unaware that antiretrovirals were being used by HIV-negative and sexually active people. So...I learned a thing.

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      Búho se PierdeBigPlops
      3/04/14 1:14pm

      Why is this not the audience? I'm so glad he talked about this here. This is one of the best things I've read on Gawker in a long, long time.

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    Rich JuzwiakRich Juzwiak
    3/04/14 1:09pm

    For those interested, here is iPrEx statistican Dave Glidden's full response to the inquiry about the varying statistics:

    "Here is my brief summary of the many numbers which describe the effect of Truvada in our study.
    42% and 44% (intention to treat): effect of Truvada regardless of pill taking
    The 42% and 44% are two versions of an "intention to treat" number. The 44% is based on the data through 5/1/10 which appeared in our NEJM paper.
    However, we followed people a little longer and we updated the results to the 42% number. I prefer the 42% because it takes into account all the infections that we know about.
    This result counts all HIV infections in the study whether or not people took Truvada. It may seem strange but this is the gold standard in medical research.
    http://en.wikipedia.org/wiki/Intention…
    Many people didn't take the pills and so there was no way Truvada could prevent their infection.
    73% Truvada effect in users determined by reported pill taking and pharmacy records
    Later, we tried to understand the effect of Truvada on HIV infections among those who actually take it. One analysis looked at who said they took it when asked about missed pills and whether they got regular refills of their drug. That analysis gave the 73%. We have since learned (through testing for drug in the blood) that many people came for regular refills and said they took the pills but didn't. So, this is not a great way to determine Truvada users.
    99% effect of daily Truvada among users determined by testing for drug in the blood
    Forty eight (48) people randomly assigned to receive truvada became infected. But 44 of the 48 had no evidence of Truvada in their blood at the time we believe they were infected.
    The amount of the drug in the 4 people who got infected were all below the levels typically seen in people who take it daily. Hence, it appears infections occurred among those who (1) were not taking it at all or (2) weren't taking it every day. At least, at the time they got exposed to HIV.
    I am oversimplifying a bit but that is the crux of the 99% result — 99% effectiveness in those who take Truvada daily.
    The summary
    Because some people didn't take Truvada, providing Truvada pills to people in the trial prevented 42-44% of infections. Nearly half of people didn't take the pills. During the trial Truvada effect was unknown, so this uptake may not reflect “real-world” use now that Truvada effect is known.
    Among those who used, it was is very effective. There were a few ways we defined "truvada use" in the trial. Users defined by asking about missed doses and refill records indicate 73% effectiveness. Users defined by testing for drug in the blood, showed infections occurred among those with no drug or non-daily levels of drug (the source of the 99%)."
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      ArturoRich Juzwiak
      3/04/14 1:03pm

      Here's my advice:

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        JoeJoeArturo
        3/04/14 1:28pm

        so you're totally okay with yourself as a person Who needs to take an HIV drug every day because there's more than just a slim chance you will have unprotected anal sex with a random person who hasn't been properly vetted by you?
        There is also the issue that people casually take a drug that is (1)super expensive and (2)needed by people who actually have a life-threatening virus.
        There is no magic pill that makes responsibilities go away. I don't care how safe you say you are 95% of the time. That 5% is going to kill you. Man or woman, whoring around is still whoring around.

        A lot of people read this and call me homophobic. I understand how it could come off that way. I'm just afraid this sort of blasé attitude about sex and disease is going to lead to the demise of a lot of otherwise smart people.

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        ArturoJoeJoe
        3/04/14 1:44pm

        I'm with you that sex is a serious thing. I grew up during the AIDS epidemic so having unprotected sex (outside of a relationship with a trusted partner) has always been anathema to me. I keep condoms handy (nightstand at home, coat pocket when out) on the off chance that I get hot and heavy with a one-night stand. Not entirely clear on your second paragraph (upset about negatives taking a drug for positives? ok) but you may want to tone it down a tad with the name-calling. Also: not everyone commenting here is homosexual. AIDS doesn't just kill t3h gheyz, it can affect us straight folks, too.

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      SpangarangRich Juzwiak
      3/04/14 1:10pm

      If insurance plans start covering this regularly as a preventative medicine, I can only imagine the right-wing shitstorm that would ensue. It would make the Birth Control/Sandra Fluke blow-up look like a day in the park. Imagine if the Hobby Lobby people found out their insurance provider covered something like this.

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        Jim PickettSpangarang
        3/04/14 1:32pm

        Insurance does cover Truvada as PrEP, so does Medicaid. We have heard of little to no denials from payors. More resistance to PrEP comes from doctors and the community than the insurance companies and Medicaid!

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        SpangarangJim Pickett
        3/04/14 1:36pm

        How has there not been backlash? Is it because it's being used for this purpose by such a small about of people so far?

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      MizJenkinsRich Juzwiak
      3/04/14 1:16pm

      When I'm single, I don't bareback on purpose usually.

      GIF
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        Tucker973MizJenkins
        3/04/14 7:00pm

        It's a slippery slope.

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        DeeLiteTucker973
        3/05/14 6:15am

        Lube generally makes things slippery

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      NathanRich Juzwiak
      3/04/14 1:39pm

      Great article.

      So let me get this straight, people are willing to pump themselves full of drugs with very little data on how they impact health longterm, put up with serious side effects, and allow themselves to be subjected to other STI's just to avoid being responsible? This says so much about the state of our species: hmmm, why act responsibly if I can take a pill to obviate treating myself with respect?!?! Perfect.

      I wish we would return to a culture of reasonability and understanding that we should be very mindful of anything we put in our body - not matter sexually or as medication. I wish us gays could just get our shit together and act like adults intend of self-indulgent children who think we should be able to do whatever we want without implications.

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        Horcrux777Nathan
        3/04/14 2:08pm

        If science can help us why not? You think it's better for people to suffer with AIDS, then to have a cure?

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        Upper-MiddlebrowNathan
        3/04/14 3:21pm

        Reasonability and understanding, man. I wish you'd read the article or tried to contemplate the variance of valid lifestyle choices that are different from your own.

        A daily medication (covered by insurance or paid for - in Canada, I would bear some of the cost of this medication up to $80 a month) is not some magic elimination of responsibilities. It's an alternative prevention method, and you could have read that one of the biggest problems with it as a prevention method is the difficulty in taking a pill daily at the precise same time (I can't imagine this being more difficult than 100% consistent condom use, but hey, different strokes.) Your freely displayed judgment and proud demeaning of people who make choices that you judge to be immoral or incorrect is contributing to stigma, and stigmatization of infection and "unsafe behavior" is what contributes to the rising infection rates. But that's a cop out, because even if it weren't, you should really try not to be such a shitty person.

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      EllenRipleyLivesRich Juzwiak
      3/04/14 1:12pm

      Having safe sex is best, why would you take a drug just so you dont have to put a rubber on?

      Besides they make condoms that are very thin and sensitive.. one night of sex is not worth a lifetime of HIV/AIDS.

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        김치전!EllenRipleyLives
        3/04/14 1:18pm

        Do you ask this question of every woman who chooses to take hormonal birth control instead of using the barrier method?

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        cheerful_exgirlfriendEllenRipleyLives
        3/04/14 1:21pm

        condoms break and anal sex can be more taxing on condoms because of less lubrication etc.

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      MizJenkinsRich Juzwiak
      3/04/14 1:19pm

      When I'm single, I don't bareback on purpose usually.

      GIF
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        jaeg66Rich Juzwiak
        3/04/14 1:14pm

        Condoms have downsides (less sensation, lack of spontaneity) but HIV and the plethora of other STDs spread through bareback sex have much, much worse downsides .Those of us over the age of 40 who are still alive generally owe our survival to using condoms and many of us have enjoyed very satisfying sex lives as well. So, I cannot understand why anybody would choose to put themselves at risk OR subject their bodies to a weird prescription medication just to avoid using latex. Besides, who wants to risk getting shit on their dick? Yuck.

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          Upper-Middlebrowjaeg66
          3/04/14 3:26pm

          Ride your high horse back to yesteryear, brave soldier of the '80s. You are never going to talk people who enjoy having natural sex into thinking it's a good idea for them, and your owing your survival to a prevention method (and a lot of luck) should make you damn fucking glad that there's now an alternate prevention method which, for many, will be much more in line with their behavioral tendencies and eliminate that inevitable shame (herein perpetuated by you) and inestimable unnecessary risk created by the idea that expecting 100% consistent condom use by the entire sexually active population is even remotely plausible.

          Also, douches exist. If you're getting shit on your condom you're still doing it wrong.

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          jaeg66Upper-Middlebrow
          3/04/14 8:11pm

          Yeah, whatever. People who ignore safer sex practices are probably not going to be diligent about a daily pill regimen. Especially after a 3 day crystal binge. But I think that decadent queens who are rich enough to spend $15,000 per year on a pill just to enjoy "natural" sex probably aren't too worried about being shamed (???) by those of us who insist that a $1.00 condom that also prevents most STDs is a better deal.

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        MizJenkinsRich Juzwiak
        3/04/14 1:18pm

        When I'm single, I don't bareback on purpose usually.

        GIF
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          WestEggMizJenkins
          3/04/14 1:25pm

          I practice safe sex often enough to consider myself "always safe," even though that's not quite true.

          GIF
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