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Yep
Commenting here for visibility since I’m seeing some confusion and misinformation in the comments.
If you’re taking PrEP daily, you should be on it for 7 days to reach maximum protection for anal bottoming: https://www.cdc.gov/hiv/basics/prep/prep-effectiveness.html
Some health organizations have guidelines for On-Demand PrEP know as the 2-1-1 method. You should talk to a healthcare provider if you’re not sure which method is best for you: https://www.cdc.gov/hiv/basics/prep/on-demand-prep.html
If you’re not yet on PrEP and want to get on it or more information, check with your local government, free care clinic, planned parenthood, etc.
https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/prep-program
https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hiv-aids/prep
Non-US residents may need to reach out to their local healthcare provider.
Absolutely. Then get on PrEP so these mistakes don’t happen again.
i restarted taking prep two days ago and this happened smh
In case you’re wondering why you’re being downvoted, I think it’s because you’re not taking ownership for your decision. Having condomless sex isn’t something that “happened” to you, it’s something you chose to do.
At this point, you should make the best decision to protect yourself, but in the long run, consider taking more ownership of your decisions (the good, the bad, and the ugly).
Isn't PeP just PreP afterwards??
The dosage is different. They need to get the concentration in your body high quickly, so pep gives you a larger initial dose
It’s usually a combination of two different medications, but one of them is a common PrEP medication.
Just stay on prep for 30 days and you’re fine.
PEP is now Prep.
Ideal protection is 7 days of prep before intercourse plus prep for 30 days afterwards. If you go in for PEP they will now just give you prep to take for 30 days.
I will never understand why they don’t tell guys to take TWO pills the first day, just to be 1000% sure about situations like OPs
That is what my doctor did and on some sites it is what is recommended. Not sure whether the CDC has changed its recommendations to start off with two pills the first day.
I don’t believe it is.
From WebMD.com:
“PEP is a combination of three drugs. You take them once or twice a day for 28 days: For adults, the CDC recommends tenofovir, emtricitabine (these two drugs come in one pill), and a third drug, either raltegravir or dolutegravir.”
If you were on prep for two days you're probably fine honestly
Yeah too bad everyone is going all fucking crazy. Topping is low risk, 2 days of prep is plenty of protection. But I knew I'd get downvotes from the simpletons on here when I posted.
Yes, everyone's a simpleton for responding to somebody asking a question.
Did you come out late in life? I wonder because you're way too old to be this juvenile, but if you just came out, I can see why.
Simpletons for downvoting the right answer because it doesn't align with their existing worldview.
You're far too old to have such a low level of reading comprehension.
So is that a yes? You're this juvenile because you're new to the scene?
I love your insults they're so bad. Keep working on it honey you'll get it soon
When gay man that are as old as you come off the way you're coming off, it screams juvenile, so I'm guessing you're just this miserable because you're coping with a lot stuff.
I hope it gets better for you. I envy you - you didn't have to lose any friends even though you're pretty old. I came out in the 90s and lost a lot of friends from HIV.
You’d be hard pressed thinking I’m not acutely aware of how much of a potato I am. And pretty stupid.
Oh you’re fine then if you stay on it. Isn’t that 2 2 3 method pretty studied at this point? (I do it daily so not sure)
There's "on demand" dosage, which is taking 2 pills 2-24 hours before sex and then one pill for the two following days. There's some debate about efficacy, but it's one of the options recommended where I am
It's important to take those two initial pills though, to get the concentration of the drug in the body high enough fast enough. I think it's about a week of daily single doses before you get to an effective concentration
That's only for truvada... What if he's on descovy?
Bro what is your status?
If you are assuming you are negative without being on PrEP you are presumptuous.
Tops have gotten HIV. It's 2023. It's unlikely but why not do something about it?
At this point all of us bros should be Undetectable/HIV positive or PrEP/HIV negative. That's how we should be looking out for each other! AIDS should no longer exist if we all did our duty.
It's the people who don't know their status or assume they are negative that are still spreading HIV.
I got tested recently and got prep, but i stopped taking them a few weeks ago
Why?
Yes. I know a man who got it from topping. Just go to a gay friendly doctor and take precautions
Test + PEP immmediately
Test again in one month or so
And I do fully believe in the benefits of PREP and other such new medical advancements we as a gay community have available to us.
It is sound advice to treat his situation as an emergency. I do not disagree with this in any way.
Sex is fun so condom first or never shouldn't matter with better communication in partners and understanding all risks especially if someone is lying to you.
Yes get on prep protect your self no one will protect your self like you !!!
Yes 100 % for piece of mind
I'm a bit shocked at some of the comments here around HIV and STI prevention, and specifically the conversations ya'll are having with you sexual partners.
OP - I think u/Ok_Perspective_4118's advice is sound.
Everyone - Here's my approach to these conversations, sharing in case it's helpful to anyone:
When I have unprotected sex, I ask my partner...
- if they are on PrEP, and;
- when they were last tested.
I ask in this order because, in Canada, you generally need to be tested every 3 months to get your refill. So, if someone says they're on PrEP, but tells me they were tested 6 months ago, then I know something is off. I find these 2 questions give me enough info to decide whether to proceed or not, or in rare cases, ask follow questions. Sometimes I'll clarify "when you were last tested, was everything negative?" if someone is being cagey or vague. I also offer up my own status and testing dates when I ask this and nearly every person receives it well. I think they may feel more comfortable with my questions when I offer up my details first. Some people may feel like these conversations are a turn off or something, (red flag IMO) but I wish they were the norm.
Did you ask his status? Have you asked his status after?
I'm not sure this is terribly meaningful. If he says, "I'm negative, tested yesterday" do you believe him? With the regular availability of PEP it simply doesn't make sense to do anything but go to the nearest emergency services.
You nailed it. The only thing “asking for status” accomplishes is to screen out the type of poz guy who is less likely to transmit than just about anyone who thinks they’re negative.
I wish we’d have an honest conversation about what bullshit “disclosure” is, how “asking status” does nothing but increase stigma and concentrate risk. Instead, we keep parading it around like it’s some mitzvah. It’s not. It’s counterproductive, dehumanizing and intrusive.
No... you nailed it. This is well-said.
right, well-said. it’s very intrusive and even carries an odor of judgment. so what is your status? people are gonna ask. and if your partner can’t handle the question, then it’s probably not worth sleeping with them. It sucks all the way around. I think we should try to remove stigma on all sides. ok to ask. ok to be truthful, whatever that is. ok to go forward or politely pass on sex based in the convo.
No. No. You’re twisting the subject. Not ok to ask because the question serves no purpose but to harm an already marginalized group. Totally reasonable that people would be offended by the question. No more “ok to pass” over this than any other aspect of someone’s medical history (that you’ve demanded under some half baked pretense of consent and absolutely batshit delusions about public health).
remove stigma on all sides
What sides are you talking about? Are you actually suggesting there’s some stigma against serophobia?! There is no “stigma on all sides”. There’s the literal prosecution, isolation and decades of unfair treatment of PLHIV. And then there is a nascent whisper of a people who have the audacity to call the former out for being monsters.
It blows my fucking mind how tenaciously some people cling to backwardness here.
One could ask when the last test was, what the result was, and how much time had passed between the test and the last time they went bb or swallowed.
It's admittedly a pretty intense line of questioning, but you'd get good information to help assess risk. I would choose to believe the person, cause I work on the assumption that people aren't psychopaths. However, human error is a thing, and the person may just not remember accurately.
No matter the answers to such questions, PEP is still a good idea. But the information is still useful. If OP is freaking out, it could help calm him down. Or it could freak him out more, and that'll motivate him to be safer with other partners while waiting a month for test results.
There are two problems:
First, people are dishonest. HIV and testing is a complex psychological issue, with people often lying even to themselves. The CDC has estimated almost half of HIV infected MSM don't know.
Second, the tests don't rule out recent transmission.
Yes. I acknowledged both of those problems in my initial comment. I should have added that you should also ask about risky contacts since the test.
I am not proposing this line of questioning as a way of completely ruling out the possibility of HIV. I'm proposing it as one of many possible tools for risk assessment / mitigation.
Calling people liars or dishonest does nothing constructive. Take responsibility for yourself first. If you're proactive you won't need to BLAME anybody.
If you are negative, go on PrEP. Top or bottom. If you are positive become Undetectable (and UNTRANSMITTABLE).
I called no one a liar or dishonest. What I said was that people are often dishonest about HIV status and testing. What I said was that people's answer to this question is unreliable.
I'm not blaming anyone, I'm suggesting that if you're concerned about catching HIV, asking someone their status as a preventative measure is not effective.
Think about it: you have an unsafe encounter. You're wondering if you should get PEP (you should), and instead of just getting it you decide to ask the dude his status. Would you depend upon his answer? Or would you decide to go ahead and get PEP anyway?
"First, people are dishonest".….yes you did say that. JFC.
" What I said was that people are often dishonest about HIV status and testing." And then doubled down on it. Not "called"?
Instead of making it about them, make it about you and what YOU can do about it.
I don't like to think people are intentionally dishonest, just uninformed. Not ignorant. Not stupid. Not evil. Not liars.
They just DON'T KNOW. And that's where we all need to take responsibility for our own actions and our community.
I don't have to care if they are dishonest, liars, ignorant or stupid because I've taken responsibility for myself. I'm Undetectable and INFECTIOUS.
You don't even need to believe that if you're on PrEP! That's the beauty of it. No judgement.
I stay away from anyone who says they are negative and not on PrEP. Too many POZ guys are still in prison for "exposing" someone to HIV (without actual transmission). That is still a risk to me.
"First, people are dishonest".….yes you did say that. JFC.
I should clarify: I didn't suggest calling anyone dishonest. To coin your phrase, JFC there's a difference between "don't ask, he's dishonest and therefore unreliable" and "don't ask, because people tend to be dishonest and therefore unreliable".
Instead of making it about them, make it about you and what YOU can do about it.
Exactly my point. You can take PEP after dangerous exposure; that's pretty effective. In the future, you can use condoms and get on PrEP. Also pretty effective. You can also rely upon asking people about their status, which is not terribly effective.
I don't like to think people are intentionally dishonest, just uninformed. Not ignorant. Not stupid. Not evil. Not liars.
'Stupid', 'evil', and 'liars' are your words. Even intentionally dishonest is your phrase. I pointed out, perhaps ineffectively, that HIV disclosure, testing, etc. are psychologically complex. It's not people running around trying to be bad, or even believing they're dishonest. It's people running around with a complex set of baggage in their heads that leads them to answer they're negative rather than admit they haven't been tested in forever, to admit that this wasn't the only unsafe sex they'd engaged in.
I've taken responsibility for myself.
Good. I'm suggesting that OP (and others) do the same. Asking someone about their status, and relying upon the answer (and why ask if you aren't going to believe?) is the opposite of taking responsibility for yourself. You may be honest about your status, but - across a population - relying upon that is not, well, reliable.
Of course it was my phrase. I said it. But I've heard it extended from being just dishonest to much worse.
I can't remember the last time someone asked if I was HIV positive. One, it's in all my profiles...they can read it. But even in bars or social situations it doesn't come up.
I live in Palm Springs/Cathedral City. Everybody is POZ Undetectable or on PrEP that I know. Two, California has eliminated the criminal aspect of HIV transmission. Never mind that I can't transmit HIV, California recognizes medical science and that it's now a manageable illness. Unlike Florida https://williamsinstitute.law.ucla.edu/publications/hiv-criminalization-fl/#:~:text=Florida%20criminalizes%20people%20living%20with,and%20consensual%20sex%20without%20disclosure. Texas prosecutes HIV under "assault".
That doesn't even make any sense. 'Ask for his status' is not, somehow, encouraging critical thought. It does nothing to address his current situation, and certainly does nothing to encourage future behavior - except maybe that he should ask about status as some kind of (ineffective) preventative measure.
Your risk of infection is low, but still worth going on PEP. Make sure you get on PREP.
Use condoms with people you don’t know. The only condoms I like are Trojan Magnum Bareskin. They’re not as good as bare back, but they’re better than getting an STD/bacterial infection.
I would suggest trying to find one or two partners that you can be with consistently. My boyfriend has two friends that only have sex with him, and I have one friend that only has sex with me.
Of course we are not naive. They could be lying, or their situation can change and they may not be honest about it. So STDs can still happen. But it’s about risk vs benefit, and this situation is a good balance if bare back sex is important to you.
PS: I don’t have a huge donger or a anything. The magnums feel better even on average size penises. If the condom is too tight it’s uncomfortable, so even for average size I suggest magnums.
You should educate yourself and use a fucking condom until you can make a informed decision...
Unless you are very endowed, like to ram the penis in without any proper lubrication nor relaxation from the partner; and play kink: like fisting. It's much less riskier for the top to contract HIV, the rates of HIV contraction for tops is similar to that of straight people in general, google it for some eye opening statistics. Either way one should always use lot's of lube and try not to engage BBK with total strangers unless you are on Prep.
Why take the risk? This is terrible advice
"You'll be fine" "The odds are" are not advice. It's starting a probability. He isn't telling him it's ok or to continue doing it. Probably just to allay his fears.
He didn't say "you're a top you don't need condoms because....."
There is neither condemnation nor condoning.
Going to ER may be over the top but contacting your doctor immediately and/or going to Urgent Care, a public health facility or a gay health clinic, if there's one in your area, is not.
Telling someone to, essentially, play the odds is not good advice IMHO
Exactly. Nor were you giving "advice". Jumping to conclusions and freaking out isn't the answer.
In the 80s some of the advocates of herding up HIV POZ gay men were Neg gay men.
Why not just ask the guy his status, or was he a random?
Go to emergency and PEP NOW
Thank you! I used a website called call on doc and got the prescriptions within hours.
Glad you did. It’s not entirely about this particular possible infection. It’s also about protecting your sanity for the next little while AND also forcing you to take a closer look at HIV prevention / education
You should ask your doctor about this. Why trust random internet users with a question that is so important to your health?
No.
I’m shocked at the amount of people saying yes.
You are less at risk when you are topping because you do not receive the same micro-lesions that you would in anal receptive sex. If you came in direct contact with his feces then ate it, maybe.
Secondly, you have not confirmed this man’s status. Whether he’s on prep, a needle drug user, tested regularly, or positive and undetectable.
If you believe yourself to be at risk, if you saw needles in his house, or believe he to be the type of person to not be on prep and receive anal receptive sex, then go for it. But it’s not something you should be anxious about. You are very safe and will be okay.
Wear a condom with one night stands?
But he didn't. Yours isn't reasonable advice, it's finger wagging, likely done did you can have a moment of smug superiority.
Others have given good advice: get on PEP. Since you are referencing my other comment, I did support he go get PEP from emergency services.
"Wear a condom" is indeed good advice...except not for OP's question. He already had unprotected sex...you did understand that part, yes? I'm guessing reading comprehension isn't a strong suit of yours.
My comment wasn't geared toward OP. It was geared toward the commenter. You really don't do comprehension or context, do you?
Preach?
Your advice is too late. Should he have worn a condom before or next time? Sure.
But preach (your word choice) does NOTHING but be judgemental.
I have no idea. But if we're saying the same thing (not type like him)....maybe listen?
Why not just delete comment?
The "reading comprehension" bit was snarky and unwarranted.
But using "preach" in the context of HIV/gay sex is judgmental. I don't think I need I need to explain how religious preaching has judged homosexuality.
"Preach, sister, preach!" Is affirmation. "Preach what you sow" is judgmental condemnation.
Not at all. I'm not now nor have I ever been smug or even electronically or literally wagged a finger.
I'm merely pointing out that this could have been avoided entirely by wearing one. I'm a huge whore so to speak. I enjoy sex and oh well but knowing i like multiple partners I'll wear a condom when I top so i don't risk any STD.
I was a whore long before prep was invented or thought of and have lived almost 50 years being promiscuous and not catching or having to worry about one thing somehow.... Oh wait safer protected sex helped me.
have lived almost 50 years being promiscuous
Your flair says 30-34
That was only thrown in there as I'm over half way to 50 to be honest
Ok so are you a 50 yo who wanted to seem younger by choosing 30 yo flair or a 30 yo who tried to pass for 50 in the convo. Based on my experience with gay men I would pick the former, but based on my experience with internet randos, I would pick the latter- so it's a crapshoot, really
Have your fun. Be a troll. I'm old enough to not care and young enough to laugh at your comment because I knew some gay or gays would clap back. Life is too short to fight with people like you in general.
My age is above in a comment. But again just to make you feel special it's 34 going on 35 and I didn't lie about it.
I in no way said I was 50 if you read my comments. I'm closer to 50 than a 21 year old is all. And you know good and well that there are individuals in the gay community who would think anyone not in their 20s anymore is old. I don't think that way but I do enjoy getting older
I'm 34 to be exact. 35 in a few weeks and greying more and more each day online unfortunately.
Only 15 more short years to 50. I'm sure it'll feel like 30 more
Whilst I agree with your sentiment, it usually helps being honest when you're trying to prove a point lol.
That guy is very incredibly self-righteous and condescending, but don't give them any fuel for dishonesty or those type of people will just use it relentlessly.
I've dealt with condescension before, but I hear what you're saying. I appreciate the comments made to him on your end as well.
Get tested first.
Taking PrEP recently won’t matter, it takes a full 14-28 days for PrEP to work.
The odds of contracting HIV as a top is 0.07-0.1% (source.
You just get tested first before starting PEP.
Furthermore, the relative risk rates are for those who are detectable in viral status. If the bottom is undetectable, those odds are stacked greatly in your favor to not contract HIV.
You only have 72 hours after the exposure to start PEP. After that, they will not prescribe it to you. I recommend getting a baseline BMP to check kidney status prior to starting PEP as well.
It does not take 14-28 days for PrEP to work. On demand dosing can start two hours before sex.
Misinformation and disinformation fs
if you're gay and poc; there's an almost 99% chance you're going to get hiv; get prep, it's free w insurance.
I know the stats are high for us, mainly because of stigma, access, availability to general healthcare in our areas ect, but is the stat that high? I haven’t looked lately but I do know we have a higher chance of contracting it.
i don't know; i only know that's what my last 2 doctors told me.
Tops don’t get infected from bottoms while fucking.
I know this is going to unleash a wave of hysteria and hatred from those who are susceptible to conventional wisdom, group-think and inexperience.
Pounding bottoms for 2.5 decades and have not used a condom since the wide spread use of the cocktail.
Certainly, other behaviours are risky.
There's a big difference between "don't/cant" and "statistically unlikely" and the main issue here is that spreading misinformation not only puts people at risk but furthers the spread of HIV, stigma, and more misinformation.
This is the standard response. Toss out this meaningless statement about risk and then claim misinformation, over and over, year after year.
But show us the infected top who got HIV from fucking alone? Can’t find him.
Your willingness to spread fear when none is warranted is what’s wrong here.
I walked through AIDS… the entire pandemic.
Please stop creating a crisis atmosphere. It’s not warranted in any way.
Hi u/MaryCone1,
You have a formal warning for disinformation. You do not know better than scientists just because you've lived long. There is a non-zero risk of HIV transmission during unprotected sex as a top and as a bottom. If you have questions about your warning, please feel free to reply to this comment.
This is fine.
But I never said I knew better than scientists and never would say such a thing.
None of them will tell you the risk of HIV transmission between top and bottom roles is equal.
And then you quantify risk. Because risk is present in everything.
Exaggeration is disinformation.
That's not the point. You claimed, between the lines if nothing else, that it's impossible to contract HIV as a top. This is wrong. Science does acknowledge that bottoms have a higher risk, but it also doesn't say that the risk is non-existent for tops. We take claims that touch on topics covered by science seriously due to the disinformation epidemic.
Making statements without context is disinformation.
There is real life risk and then there is theoretical risk.
Making these points does not mean that I am pro scientific disinformation.
It is, when you don't know your audience. Which you cannot, with over 70k members in this community. Now you know how we reason here, and can act accordingly in the future. Next time, just link a scientific source that talks about the risks.
I mean I only have HIV, its not like I would know anything about it 🙄🤦🏼♂️ just because you've been fortunate enough to not contract it doesn't mean it's not possible. It's better to be careful than to be careless.
I would get tested first
Wouldn't show anything. PEP is the way to go.
That so dumb how a test is not going show anything?
Because HIV can take months to show up in a test but PEP must be started within 72 hours of exposure.
28 days days not months. So you’re saying that if he was infected that he shouldn’t know? And continue to have unprotected sex as long as he’s on a pill?
u/No-Substance1616 what he is trying to say is. If OP DID test immediately there is no test in the world (available to the public at least) that could detect that he has in fact contracted the virus.
It would take on average 2+ weeks for anyone to test positive even if they do in fact have the virus in side of them.
I agree with you, it is dumb, but currently that is how the science and testing works.
The general rule of thumb is if you think you have been exposed you should start PEP immediately, test frequently during and after your PEP regimen and then immediately get on PrEP and stay on it for the rest of you life.
So you’re saying that if he was infected that he shouldn’t know? And continue to have unprotected sex as long as he’s on a pill?
That is not at all what I'm saying - that's a pretty big leap. But I kind of get why you could read it that way.
I think most of us were/are commenting under the assumption this event for the OP is in the immediate past, within a period when an HIV test result would be unreliable but PEP would be effective. That's all. If he's concerned about exposure he should get PEP and he should have tests at the appropriate timeframes to determine his status. I mean, any of us who are sexually active should be getting tested regularly anyway.
That said, if the OP is going to have unprotected sex, he should at least discuss PrEP with his doctor and should probably be on it.
You must get a baseline HIV test prior to starting PEP. If the patient already has HIV and doesn’t know it, PEP is contraindicated.
Oh. I stand corrected. I thought it was only for PREP.
I’d strongly suggest you speak to a primary care physician or an infectious disease physician. Explain your situation, and get expert advice. Not the self proclaimed experts on here.
Yeah, PEP is a great resource and as others have mentioned, PrEP is great and many cities have resources that can work with folks to get PrEP at low or no cost. While it is less likely for transmission to occur when topping than it would be for receiving anal or vaginal sex, this could definitely be considered a potential exposure so I’d say the best step for risk management would be to contact a provider and seek out PEP.
I'm assuming this has been answered, but just heads up for anyone that's in a similar situation and is recently on Prep/back on prep, you should learn about prep on demand
Just as a footnote: Ironically, these days, someone is more likely to catch hiv from an anon partner who thinks he's neg vs. a partner who knows he's poz
The poz guy is taking meds to keep his viral load undetectable thus untransmissible. And he sees his doc regularly to monitor it.
A guy who THINKS he's neg may not realize he's seroconverted thus has an ever increasing viral load making him infectious. Also, unknown how regularly they see their doc and get tested.
If you’re having unprotected sex you should be on prep. If you’re using protection you should be fine.
Self Mandatory disclaimer that HIV isn’t the only STD out there, and tbh it’s much more mild nowadays with proper treatment than some other STDs
Thank you! I have got the prescriptions!
It takes 10 to 30 days minimum for HIV to show up on a blood test.You need to take post exposure within 72 hours of exposure. EVERY HOUR COUNTS - Treat it as a medical emergency. So yes, go to the ER for post exposure, they'll put you on a cocktail, you'll be tested before it, though it wouldn't show this most recent happening. Then you can start taking PREP after that 30 days of PEP treatment. Better safe than sorry.