PReP has some side effects. While they are rare, they are things you need to be aware of. If you are not doing risky sex it isn't for you.

Most people want to believe they are in a monogamous relationship and thus not having risky sex - even though they are the one cheating. Either PReP needs to be more common, are people need to stop their risky sex activities (that they are not even admitting to).

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nerdjon 4 hours ago | parent | next [-]

> If you are not doing risky sex it isn't for you.

That blanket statement I very much disagree with. Sure there are side effects but that is part of why you also get tested every 3 months for liver issues (not that it is the only side effect, but still).

Instead of it being a blanket statement it should be a conversation with your doctor about the pros and cons.

You can still get HIV even if not engaging in risky behavior. Same with people getting pregnant when they did not intend too.

I am thinking college kids that are still figuring out their sexuality and exploring new things. You're going to make mistakes so having a conversation about prep with your doctor is a really good idea.

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Telemakhos 4 hours ago | parent | next [-]

You are extremely unlikely to get HIV from anything other than risky sex. That's what "risk" means: it's another word for "probability," just a probability of negative outcomes. These probabilities are known: https://www.aidsmap.com/about-hiv/estimated-hiv-risk-exposur...

Some of that table is already mitigated: we test blood for HIV, so transmission by blood transfusion is unlikely. Transmission by pregnancy is less likely simply because few women have HIV: 80% of new cases in the US are male, 20% female.

The real question is whether "having a conversation about prep with your doctor" is going to lead to someone caring enough to pursue a prophylactic course of medication when that same person doesn't care enough about his own health or others' to avoid risky sexual encounters. Is someone irresponsible enough to pursue causal, unprotected sex with random partners also likely to be responsible enough to visit a doctor proactively and comply with a prep regimen? Sure, it's a "really good idea," but a simpler and better idea is not to have random sex in the first place. A "really good idea" depends on a level of self-control that some people obviously lack.

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camphy 3 hours ago | parent | next [-]

> Is someone irresponsible enough to pursue causal, unprotected sex with random partners also likely to be responsible enough to visit a doctor proactively and comply with a prep regimen?

Yeah, me. What a wild statement to make. It’s a big world out there, my friend.

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vasco 3 hours ago | parent [-]

You may have missed the word likely.

	▲	camphy an hour ago \| parent [-]
		Did I also miss the part where “likely” was shown to be grounded in anything other than a prejudice about people who have “risky” sex?

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matthewmacleod 3 hours ago | parent | prev | next [-]

Is someone irresponsible enough to pursue causal, unprotected sex with random partners also likely to be responsible enough to visit a doctor proactively and comply with a prep regimen?

Anecdotally, very much so - at least among the gay/MSM community.

The thing is, people generally quite like having sex. That comes with some level of risk, which can be mitigated in various different ways - and PrEP is one of those tools.

All humans engage in some level of risky behaviour; evidence suggests that moralising about “responsible behaviour” or “self control” is rarely effective at mitigating that risk.

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nerdjon 4 hours ago | parent | prev [-]

> You are extremely unlikely to get HIV from anything other than risky sex.

Yes because it is such a fantastic idea to just ignore that there is still a risk regardless of what we call "risky" sex just because it doesn't fit in your puritanical views of sex.

If someone can get HIV the first time they have sex than your entire argument is moot.

Just have the conversation with your doctor and protect yourself and stop trying to push your views on others.

This is such a simple thing to say, talk to your doctor. Thats it. If doing so stops one person who is not engaging in anything that we would deem being risky from getting HIV, that is a win. There is nothing in your world that would stop someone who is having sex with someone that maybe they have been going on several dates, from getting HIV from that person if a mistake happens.

And yet, you seem to think that we are saying that you should be going to an orgy every other day.

Oh and let's not ignore that there are monogamous couples that one may have HIV and they need to also protect themselves.

	▲	UltraSane 4 hours ago \| parent [-]
		Are you arguing that all sexually active people should take prep?

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bluGill 4 hours ago | parent | prev [-]

I don't see how you are disagreeing. We are both saying that a lot more people are having risky sex than think they are.

	▲	nerdjon 4 hours ago \| parent [-]
		I guess it depends on what we call risky, I mean if someone is actively trying to get pregnant are we considering that "risky"? Someone could be taking the necessary precautions and a mistake happens, a condom breaks, whatever. Someone could have sex with one person in their life and they got it from that person. I would not consider that "risky" in any real sense of the word. Any sex carries some amount of risk, and the key is being risk aware and not assuming that just because you are not engaging in what is generally deemed "risky" that you are safe. Instead you should be having that conversation with your doctor and determining what your risk tolerance is. That is where I disagree, how many people are positive that never considered themselves engaging in risky behavior. To me it is very dangerous, and leads to the situation we are in now, to just say only even consider prep if you are engaging in risky behavior.

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simonask 4 hours ago | parent | prev [-]

All sex is risky by this measure.

Condoms break. Partners lie. Shit happens.

It doesn’t take a lot for the risks to far outweigh any potential side effects. As far as I’m aware, every healthcare system in the developed world either recommends or enforces checkups after starting PrEP.