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Author Topic: PrEP for tops  (Read 1237 times)

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Offline Daniel1

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PrEP for tops
« on: July 06, 2017, 04:36:28 pm »
Hi there,

I am wondering if you can advise about PrEP if you are the active partner, particularly event-based dosage.

Online it says event-based is fine for anal - however if you delve deeper, it often then says rectal issue. For the active partner, the relevant tissue is obviously penile.

Is event-based PrEP just as good for the active partner? I assume yes since it says it's fine for anal sex in general, but I want to check.

Thanks!

Offline Ptrk3

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Re: PrEP for tops
« Reply #1 on: July 06, 2017, 04:43:11 pm »
If you are asking whether using PrEP would greatly reduce/eliminate the chances of contracting the HIV for the so-called "top" in unprotected anal intercourse, the answer would be "yes."  PrEP acts effectively regardless of how the HIV may enter the body.
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Offline Daniel1

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Re: PrEP for tops
« Reply #2 on: July 06, 2017, 04:51:41 pm »
There appears to be different guidelines for different parts of the body, however - event-based dosage specifically says it is not suitable for vaginal sex, only anal, since it takes longer to become effective in the vaginal tissue.

So my question is whether it is equally effective in the penile tissue as in the rectal tissue, or if for the penile issue (ie for the active partner), if event-based is not suitable.

Offline Ptrk3

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Re: PrEP for tops
« Reply #3 on: July 06, 2017, 05:34:23 pm »
I don't know if anyone can determine whether one thing or another is "equally" effective, since when are all things "equal," really?  It's effective or it isn't, in other words--somethings are binary.

I'll leave it to other forum members (who may have a broader research perspective on such things, if such research exists) who may be able to give you the type of "exactitude" you may be seeking.

If you really want to be sure, why not use a condom?

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Offline JimDublin

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Re: PrEP for tops
« Reply #4 on: July 07, 2017, 02:18:45 am »
Quote
There appears to be different guidelines for different parts of the body

Would help if you could provide that evidence or guideline as I would not have seen any. Its not as if there is any guideline saying take 1 if anal concern and take 1 with tea is penile concern

The medication works inside the human body by blocking HIV from attaching itself to the cell (I know that a very crude description) but in essence true and where the cells are located in the body is not of much concern.

Its an additional layer of protection and safer sex is often a combination of things to reduce risk so next to this use condoms if concerned.

Jim 
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Offline leatherman

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Re: PrEP for tops
« Reply #5 on: July 07, 2017, 08:08:58 am »
event-based dosage specifically says it is not suitable for vaginal sex, only anal, since it takes longer to become effective in the vaginal tissue.
PrEP is recommended for vaginal sex; however, it takes 20 days of adherence to reach the right level for best protection while it only takes 14 days of adherence to reach the best protection for anal sex. This is mainly because of the different types of tissue in the vagina and anus. After this initial start-up period, daily adherence keeps the same level of protection for either type of sexual intercourse.

I don't know that "event-based" is the right word choice here. PrEP must be taken daily and not per "event". There is no such thing as event based "dosage" nor dosage change based on the type of sexual intercourse.
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Offline shlc76

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Re: PrEP for tops
« Reply #6 on: February 08, 2018, 12:17:19 am »
I don't know that "event-based" is the right word choice here. PrEP must be taken daily and not per "event". There is no such thing as event based "dosage" nor dosage change based on the type of sexual intercourse.

Event based PrEP is totally a thing, mostly in France, who is who developed the studies that validated its efficacy.

2 pills the day you'll have sex, then one pill every day during sex days, until two days later.

http://www.catie.ca/en/catienews/2015-03-19/demand-prep-strategy-highly-effective-gay-men-who-have-frequent-sex

Offline marseilliais

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Re: PrEP for tops
« Reply #7 on: April 17, 2018, 03:03:05 am »
Event based PrEP is totally a thing, mostly in France, who is who developed the studies that validated its efficacy.

2 pills the day you'll have sex, then one pill every day during sex days, until two days later.

http://www.catie.ca/en/catienews/2015-03-19/demand-prep-strategy-highly-effective-gay-men-who-have-frequent-sex

For anyone who's still interested, here's the journal article that shlc76 is talking about that was published in the New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMoa1506273

"In this study involving high-risk men who have sex with men, sexual activity–dependent preexposure prophylaxis with TDF-FTC was associated with a relative reduction of 86% in the risk of HIV-1 infection."

It's not 92% that is with daily adherence, but close enough.
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