My brother is on Prep, but thinks he's invincible

[BMB0410]

My brother is new to being sexually active. I was proud of him for taking the necessary precautions and getting on prep. But he thinks he is invincible to all STD'S now. I tried to tell him that is only good to help prevent HIV, and probably 95% of the strands. But there's still Hep C, herpes, syphilis, etc. We're 10 years apart. He's gay, I'm a lesbian. He's 22, I'm 32. I don't know how to properly talk to him without him thinking I'm just being a dumb old sister and I don't know anything. I just want him to understand he still needs to use a condom no matter what!  Even if the guy is in a hurry, or swears he's clean. So, how do I do this the correct way, where he might listen? Or is it a loss cause. He basically told me he only sleeps with people whom his friends know, and can vouch for them. And if he does get something, then that person will lose a lot of friends for lack of trust. It sounds very immature to me. But he is young. Thank you for reading.

[Jim Allen]

Hi

Well he's on a sure path to catching an STI sooner or later, if he has not done so already.

I agree he does not have a safer sex strategy in place but it is his life and his decision at the end of the day and if he does not want to listen there is not much you can do about this if I'm honest.  He is an adult and its up to him.

Jim.

[BMB0410]

Thank you for the response. I agree with you as well. I guess I'll just continue naming my grey hairs after him. I'll stress for him. I just hope he grows up soon, and finds a good boyfriend/partner and settles down at some point before he gets something from not being careful. No matter what though. I'm always going to be there for him. And I hope he knows he can talk to me. I just hope I didn't give the wrong impression trying to talk to him about being safe.

[mecch]

My brother is new to being sexually active. I was proud of him for taking the necessary precautions and getting on prep.

PREP is hardly a "necessary precaution".  Millions of people avoid HIV by using condoms.

I just want him to understand he still needs to use a condom no matter what!  Even if the guy is in a hurry, or swears he's clean. So, how do I do this the correct way, where he might listen? Or is it a loss cause. He basically told me he only sleeps with people whom his friends know, and can vouch for them. And if he does get something, then that person will lose a lot of friends for lack of trust. It sounds very immature to me. But he is young. Thank you for reading.

He doesn't need to use a condom if he only wants to avoid HIV.  Yes barebacking on PREP is not the recommended use of PREP but it has become the defacto use of it by many urban gay men on PREP.   You can't argue with that.

Your brother is naive about all the other stuff.  I don't know very much obviously, but he seems to want to avoid the issue of responsibility in sexual choices. Thus his decision to take PREP, which again, is not "necessary", and think everything else is covered by trust and reputation.  Is he dumb?  Sounds dumb.  Or deeply deluded about life. Most of the gay men I know who choose to bareback, they acknowledge the risks and inconveniences of STDs and take them in stride. They don't "wish away" or "dream away" the risk.  So maybe you could encourage him to just be more realistic. I know a guy who goes to big sex weekends around Europe and then he comes back and takes antibiotics for clap and chlamydia and gets tested 4x a year for syphilis. Proactive and reasonable.  But costly of course.

As Jim says, the man is an adult and is going to make his choices.

If you want to be practical, does he have good health care coverage? Because people who bareback will pick up some STDS and will probably want diagnosis and treatment and it can get expensive. Is the HEP C treatment going to be automatically accepted and paid by his insurance? Tell him to verify that.  HEP C treatment is about 75K.  Here in rich Switzerland, the insurance companies are refusing to pay that for most people with HEP C.  Nice, right?

As small matter - could you please not use "clean" to refer to HIV- people, or people without STD?  Thank you.  I know that's what a lot of people say and you are reporting it as speech but still....

Anyway, many if not most sexually active gay men have some STDS, such as HPV, so we are all "dirty" so you could point out this fact to your brother, along with the cost of HEP C treatment, or any doctors visit, for that matter.

[zach]

clean/dirty... it's not a small matter, it's offensive as all hell

your judgement of us shines through both of your posts

not appreciated at all

[LukasAtlPZ]

My brother is new to being sexually active. I was proud of him for taking the necessary precautions and getting on prep. But he thinks he is invincible to all STD'S now. I tried to tell him that is only good to help prevent HIV, and probably 95% of the strands. But there's still Hep C, herpes, syphilis, etc. We're 10 years apart. He's gay, I'm a lesbian. He's 22, I'm 32. I don't know how to properly talk to him without him thinking I'm just being a dumb old sister and I don't know anything. I just want him to understand he still needs to use a condom no matter what!  Even if the guy is in a hurry, or swears he's clean. So, how do I do this the correct way, where he might listen? Or is it a loss cause. He basically told me he only sleeps with people whom his friends know, and can vouch for them. And if he does get something, then that person will lose a lot of friends for lack of trust. It sounds very immature to me. But he is young. Thank you for reading.

Your brother should also be vaccinated against Hep-A/B and HPV. Hep-B is much more infectious than HIV and an acute infection can kill. HPV is very painful and inconvenient. He should also be getting tested for all the usual STDs every 3 to 6 months.

[zach]

How do we know he hasn't had those vaccinations? In fact, we can make inferences he probably has had them. Read her posts objectively, the young man took the steps to get onto PrEP. Obviously, he is medically supervised and monitored. He is getting regular STD screenings as a normal part of follow up care for PrEP. Sounds to me like he has considered his risk factors.

I just want him to understand he still needs to use a condom no matter what!

That statement is the crux of her position. How many of us have had negotiated barrier free sex with a negative? hmm? No matter what? Really?

I'm not on this bandwagon, I feel like OP is well intentioned but heavily biased and should consider minding her own business.