My Gay friend thinks PrEP is the equivalent of the pill; aibu to think, "eh, no."

[TheCraicDealer]

And when I say "same", I mean sexually freeing, for want of a better term.

My mate has just come back from Oz where he's been living for the past year whilst also trying to fulfil his dream of being a writer specialising in gay sexuality/applying to do a PhD in gay sexuality in literature. The last few months he's been banging on about PrEP on Facebook. It's a drug which prevents the spread of HIV between partners, which I think everyone can agree is amazing and a Very Good Thing.

We were discussing this and he was saying that a frequent (but not only) sexual partner of his had been on a program which was running in Oz- one of the reasons he'd been writing so much about the drug. Said fella didn't have a partner with HIV or anything, the point of him taking it was so he could remove the anxiety about sleeping with different people (strangers) regularly.

Now at this point I was like, "OK, dead on, but what I'd worry about if that became widespread is that people wouldn't use condoms as much as they do now and we'd see an increase in other sexual diseases". Then my friend said, "Well, I don't think anyone would say that women shouldn't go on the pill just because they might catch an STD".

At this point I was just thinking, "are you seriously comparing the first thing that really gave women autonomy over their own bodies to a drug which means you don't have to worry if you have a question mark over your next sexual partner?". It left me with a bit of a sour taste in my mouth. The fact that women were so frequently trapped or endangered by pregnancy before the pill just seemed completely at odds with the threat of HIV infection in 2015 with reducing infection rates, easily accessible testing and condom use.

But now I'm wondering if I'm being unreasonable, and whether I'm 'just' being judgemental because I don't think it's sensible to pump your body with a serious drug so you worry less about having unprotected sex with strangers. And fwiw, this friend and aforementioned fella managed to pass gonorrhoea between the two of them because they'd dispensed with condoms due to one of them being on PrEP. DFriend also says he doesn't give bj's with condoms because "ew", and it's apparently a low risk activity.

So aibu to be shirty about this?

[noeffingidea]

Why are you getting shirty?
Your friend is uninformed, and risking his health as a result. Personally I would be afraid of contracting the new strain of antibiotic resistant strain of gonorrhea, if I was practicing unsafe sex. Not to mention hepatitis and other conditions that are sexually transmitted. HIV is only one.
People just take ridiculous risks with their health but adults are free to do that if they choose.

[QueenLaBeefah]

He sounds like an idiot.

[KP86]

PREP sounds like a fine idea until you read the side effects. Kidney failure, osteoporosis, heart issues... all because men don't want to wear condoms with new/untested partners.

If you were with someone you knew was HIV positive, I guess I could understand taking the risk of the side effects in order to prevent contracting HIV. Otherwise, is it worth it?

Agree that it doesn't stop other STIs, which will probably also increase again now.

[originalusernamefail]

I always thought PrEP had some fairly nasty side effects? It may have advanced now but during my nurse training a colleague was put on a PrEP course for 6 months (?) following a needlestick from an unknown donor. She became increasingly unwell however it was put down to PrEP however it was NHL unfortunately by the end of the course she was too far gone and passed away.

[TheCraicDealer]

I dunno noeffing, it just really pissed me off. The only thing he posts about (and talks about, to a certain extent) lately is being gay and how sex relates to that and his sexual relationships. If you don't play into that or say anything with detracts from his version of the world he starts going on at you like you're a small town yokel. I'm really happy that he's living the life he wants to live but he seems to be getting really narrow in his outlook on life. It's like something so integral to women's sexual freedom, like the pill, is still brought round to (and stupidly compared to) a gay issue. I was just thinking, "the pill? Really? Can you not let us have that one?".

As for side effects, we discussed this. He was like, "oh you might get nauseous because it fucks with the flora in your body and that but most people get used to it after a few weeks". DP is in the army and they get chats on it (for men who are considering going with prostitutes on tour) and they're told it's like having flu for six months. I suspect the truth is somewhere in between unless you get kidney failure.

[CallaLilli]

The only thing he posts about (and talks about, to a certain extent) lately is being gay and how sex relates to that and his sexual relationships

Sounds like a few of the gay men I know, who also happen to be highly misogynistic, although they would point blank deny it.

[7Days]

what does NHL mean?

[Cerseirys]

Non-Hodgkins Lymphoma?

[noeffingidea]

Gay men are also at risk of HPV related cancers of the mouth, throat and anus, (assuming they practice unsafe sex).
Hetrosexual women are starting to be protected by gardasil, this will be offered to gay men but hasn't yet been started. (personally I think it shouod be offered to all teenagers).
I think it's dangerous to assume that Prep is a permit not to use condoms . Neither is the pill.

[VestalVirgin]

He is ignorant.
Of course no one likes to think about the fact that women are often coerced or tricked into sex without condoms, and that stranger rape is also an issue on top of all that.
But it's an issue, and in some well-informed texts about contraception, methods are also compared with regard to whether they can be tampered with or noticed by a male living in the same household with the user. (Injections and implants are worse than the pill, side-effect wise, but cannot be noticed or tampered with, for example)

Gay men's unwillingness to use condoms is a completely different issue. Not to mention the fact that gay sex without danger of HIV infection is totally possible ... people can get tested!

Of course this medication should always used along with condoms. It's just an additional precaution. (And one that I guess is very useful for people whose partner is HIV positive - I wouldn't feel safe enough with condoms only with a known HIV infection.)

I've read articles that other STDs are on the rise since people aren't so afraid of AIDS anymore. Apparently, nothing less than certain death scares some people into using condoms.

@noeffingidea: I never got gardasil, I am angry that it's only given to girls while boys are the ones who spread HPV. It is the typical attitude that is also behind the pill - shove the responsibility onto women.

Even if men wouldn't get cancer from HPV, they should be immune to it so that they don't spread it to women who can't get vaccinated for some reason or the other.

It is universally acknowledged that it is shitty behaviour to not have your child vaccinated against measles, as there are immune-compromised children who cannot get vaccinated and would suffer for it, but with HPV, it's suddenly okay? Why?

[noeffingidea]

vestalvirgin gardasil was initially given to girls because women are most affected by the HPV , in the form of cervical cancer. Why on earth would you be angry about that?
These are health issues, not a matter of 'who spreads what', or shoving responsibility onto women.
As a parent, I would prefer both sons and daughter to be protected. If I had the option, I would prefer to be protected myself, rather than relying on my partner being protected.
At the moment the plan is to extend the vaccination to gay men, as they are the next most at risk group.Hopefully biys will eventually be offered the vaccination at the same time as girls.

[GreenTomatoJam]

"Well, I don't think anyone would say that women shouldn't go on the pill just because they might catch an STD"

Religious zealots say that all the time.. but that's beside the point.

When you go on the pill, you get the chat (or at least I have, at different GPs even in different countries, each time I've started it again - so 3 or 4 times) - they always tell me that the pill can fail, what makes it more likely to fail, and that it doesn't protect against STDs so with a new partner I should use barrier protection. Every time.

The point of the pill wasn't to enable us to freely have sex (although that's a lovely side effect) it was to enable us to have a bit of control over whether that sex made us pregnant, and that's an important switch of perspective.

I actually can see PrEP from a similar angle - the point is to allow someone to have safer sex with someone who has HIV, which isn't quite the same as taking its point to be that you're protected from HIV so can now have sex with everyone willy nilly.

[VestalVirgin]

vestalvirgin gardasil was initially given to girls because women are most affected by the HPV , in the form of cervical cancer. Why on earth would you be angry about that?
These are health issues, not a matter of 'who spreads what', or shoving responsibility onto women

Men are spreading HPV. They're the Typhoid Marys of HPV. That vaccination has risks. Risks that are shoved onto girls. Because men don't feel any consequences (except nasty genital warts, but apparently those aren't bad enough to warrant vaccination) women are expected to bear the burden - like with pregnancy.

Lesbians are at almost no risk of HPV. (If they aren't raped by men, that is) Same for nuns. Being female doesn't make you automatically at risk. Having sex with men does.

Maybe it makes me so angry because I know there is some history behind that. In the Victorian Age, prostitutes had to submit to medical procedures whenever a doctor felt like it, to "prevent the spreading of STD" - instead of looking at the johns, they subjected women to humiliating, non-consensual examinations.

[JessicasRabbit]

The purpose of gardasil is to prevent cervical cancer, not genital warts. I doubt they'd get the same numbers of parents immunising their children if it weren't to prevent a fatal illness. The risks of the vaccine are worth it (for many parents) when weighed against the risks of cervical cancer. That may well not be the case of it were only protecting against genital warts.

All vaccines carry risks. In deciding whether a vaccine is an acceptable risk, the seriousness of the illness itself really matters. Which is why we have vaccines for measles, tb, polio etc. A vaccine for genital warts may not pass the "does significantly more good that harm" test.

Then there's the cost. The nhs cannot fund everything. Funding a vaccine for a cancer (which is very expensive to treat) - fine. Funding a vaccine for genital warts (which are usually not expensive to treat) - not fine. That's why the annual flu vaccine is only offered to those who are at risk of developing (expensive) complications. Immunising every child would double the cost of the vaccinations without significantly reducing the cost of later treatments.

Back to the original point - maybe he sees it as a gay rights thing. I thought there were higher rates of HIV among gay men when if first hit the headlines. I also seem to recall a question on the giving blood questionnaire about men who have had unprotected sex with another man being banned from giving blood. I'm not very up on gay rights history though, and your friend does seem to be ignoring the risks of other STDs.

[VestalVirgin]

All vaccines carry risks. In deciding whether a vaccine is an acceptable risk, the seriousness of the illness itself really matters. Which is why we have vaccines for measles, tb, polio etc. A vaccine for genital warts may not pass the "does significantly more good that harm" test.

Are you familiar with the concept of vaccination coverage?

Just because men only get genital warts themselves (except in the rare cases when they do get penis cancer) doesn't mean they don't spread a potentially deathly disease to women. Every man infected with HPV means at least one woman is at high risk of cervical cancer. (Or another man at high risk of anus cancer, whatever)

Vaccinating all boys would have more of an effect than vaccinating all girls, as lesbian women don't spread HPV while gay men do.

But of course, spreading a disease to other people is considered as less serious as getting ill yourself in this society. There's a lack of accepting responsibility for the things you do.

If this vaccine was given to consenting adults, okay. But it is given to girls, who may turn out to be lesbian, or become nuns, and not need it anyway.

[Mince314withIcecream]

I've learnt a lot from this thread, But OP, I see why you're put out by the comparison your friend makes.

tbh, I've a gay friend and some of the things he comes out with are a bit, omg, have you thought that through,........... but he is a very funny and warm character. Another gay man I used to work with, I never knew a gay man could be so misogynist. I don't know why he was so invested in to hating women but wow...

[JessicasRabbit]

I do understand vaccination coverage, and as a consenting adult I may choose to get vaccinated in order to protect others. Like if I were offered the flu vaccination to help stop the spread and protect those who are unable to get vaccinated I'd probably choose to do it. But when it comes to children, I'm not sure that it's okay to give them a vaccine to protect others. I get the logic, and I'm probably being unreasonable, but I'm uncomfortable with the ethics of giving a child a vaccine mostly to protect others.

It's not that spreading the disease to others is less bad, it's just that I think that it should be a choice adults make for themselves. If it were a vaccine which had been around of a while (like rubella) I'd be more comfortable with it. But I also know that's a gut feeling rather than a scientifically reasoned one.

Interesting point about it being more effective if only boys were vaccinated. I hadn't considered that, and don't really understand it. Surely vaccinating any half of the population would be equally effective? Like if only those born Jan-June were vaccinated that would be as effective (in terms of vaccination coverage) as only vaccinating girls?

Tho I think the idea of vaccinating everyone and getting rid of the whole thing would obviously be preferable. Like the fact that I've never known anyone irl who has had tb, measles, polio, etc. But then we run in to the funding issue.