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Approved for love +U SLSA

Approved For Sex :-)

The evidence now appears overwhelming if you have and maintain undetectable viral load you are NOT INFECTIOUS (e.g. Swiss Statement, HPTN052, PARTNER & Opposites Attract studies), there are zero examples of linked infections when someone has an undetectable viral load.

This knowledge and understanding of what undetectable viral load means has not yet fully permeated the consciousness of the communities we socialise and have sex with. So I am seeking opinions and comments on the following pics ( +U concept ,credit given to an individual who posted in the Facebook group TIM-The Institute of Many).

Approved for love +U SLSA

Approved for love +U Back  Approved for love +U

Picture A

 

 

 

 

 

Picture B

 

 

 

 

Picture C

 

 

Thank you for participating in the poll and I appreciate constructive comments🙂
I will edit the post to reflect the votes given, publicly or privately.

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Ignorance Hurting Young Gay Men: 2014 Horror Year for HIV in WA

The latest HIV surveillance report published by the WA Department of Health records the worst HIV statistics for gay men in the past 5 years. Two men under 19 and 24 gay men under the age of 29, who engaged in their natural birthright to have love, sex and intimacy also unknowingly acquired HIV. 26 gay men (aged between 30-39), 19 (40-49) and 7, fifty and above also unknowingly acquired HIV by the year ending 30 September 2014. Almost 30% of the gay men (23 of them) self reported acquiring HIV while overseas. Whether it was New York, L.A. London or Bangkok, WA is grand importer of HIV. So what could we do about it?

Stop thinking you can avoid HIV by saying so on your profile. Claiming that you only BB (i.e. bare back) so you only want to meet neg guys will not stop HIV, why? Because most of the HIV acquired overseas and in WA, is from guys who don’t test (or test often enough) and don’t know they have it. Logically people assume if I only have sex with neg guys I’ll never get it, the problem is we don’t actually know that we are negative (because we fuck BB more often than we test). Many of us just prefer to trust that we’re neg and assume the same in others. Truth be known, the HIV test currently employed is inadequate for the sexual life of many modern gay men. In can take up to 3 months to be accurately cleared of HIV, by which time many guys have already hooked up again and BB’d through their favourite mobile app. How many of us change our profiles to status unknown after we BB or say so when we are hooking up with Mr Next?

Imagine being a young guy just diagnosed and you’ve previously heard your friends trash talk or joke and trivialise people with HIV. What are your chances that a close friend who is newly diagnosed might just simply slowly withdraw from you and the scene or instead go extreme? Your ignorance about your friends living with HIV could be hurting them and you. When we hide from each other because of ignorance, stigma, fear of discrimination and judgement, our whole community is diminished. We hurt our friends and we hurt ourselves, we could be losing friendships, lovers and perhaps even the support we ourselves might need one day.
Do you know a person with HIV? you don’t? why not? There are approximately 2000 people living with HIV in Perth, the majority are still gay men. Could our own ignorance and fear behaviour be blocking an opportunity to grow, be real and loving? No one expects you to love a virus, but you can love a person living with it and have hot safe sex with them too. As a person with HIV who has been in a pos-neg relationship for almost ten years, I can vouch for love overcoming ignorant fear.

So how we going to reverse the past horror year of HIV? Well for some of us it means using condoms more often. For others it means getting tested more often. If you are diagnosed with HIV it means going onto treatments immediately for your health and so you’re not infectious. When overseas, knowing that you’re going to be big on parting, playing and somewhat condom challenged, be sure to demand and take your before pill Truvada to prevent acquiring HIV, so far if you take it as prescribed its 100% effective. Email me at positiveadvocate@hotmail.com if you’re having trouble locating a friendly doctor. Also take Truvada if you simply prefer to BB.
lastly as we start the new year lets choose to become less ignorant, less fearful and less hurtful to each other, have a most awesome, abundant and STI absent 2015.

What Do We Want? HIV Cure! When Do We Want it?

Now please! In December 2014 I wrote an article in OutinPerth encouraging people to get active for HIV cure research

What Do We Want?-HIV Cure!- When Do We Want It?
Ahead of the July 2014 International AIDS Conference in Melbourne hopes were high that HIV scientists from around the world would unveil the promise of a much anticipated HIV cure. Headlines of imminent breakthroughs that could lead to a cure for HIV have tantalised the community for years. Sensationalist headlines included ” Danish breakthrough for HIV expected within months”(April 2013).

Instead days before the main conference at the Towards An HIV Cure Symposium organised by the International AIDS Society sobering commentary was shared about the rebound of HIV in both of the two patients from Boston (who received a stem cell transplant) and the Mississippi baby (who after acquiring HIV in the womb received HIV meds within 30hours of delivery). Science is about advancing knowledge which is gained both from what does and doesn’t work. Optimistically we now have proof that we could extend the time it would take for HIV to return/rebound from the usual one to 4 weeks to 4,7, and 27months respectively. Progress indeed, but not the immediate cure that so many people hope for. Getting comfortable with the idea of “HIV remission” maybe an intermediate step that we may need to begrudgingly accept as the next step in HIV cure research

Fortunately for humanity HIV scientists are continuing to meet and where possible collaborate with each other. The latest international meeting occurred In October 2014 Washington D.C. at a conference hosted by the USA National Institute of Health titled Strategies For An HIV Cure 2014. Topics included; Gene Editing and Cell Based Strategies, Immune Based Strategies, Social Ethical & Community Aspects of HIV Cure Research and Strategies to Reverse Latency. Science can be dense and complicated, while its flip side reveals inspiration, talent and our best efforts for human advancement.

Most recently on the 28th of November this year Professor Sharon Lewin, Director from the Peter Doherty Institute for Infection and Immunity(and Melbournian of the year 2014) hosted a community roundtable on Building Partnerships For An HIV Cure. Recognition of community and its contribution to cure research is fully acknowledged by Professor Sharon Lewin with an early partnership approach adopted with the National Association of People With HIV Australia along with other essential community partners.

There are some in the community who do not believe that it is worthwhile dedicating resources to a HIV cure research agenda, believing instead that funding is already stretched and may displace resources from treatment and prevention. The logic is very understandable, and we are all challenged with making choices and trading between opportunities. However the history of HIV has shown that short term either/or positions is detrimental to our long run interests, where both/and thinking has delivered to us the stunningly effective idea of ‘Treatment As Prevention’, where people with HIV successfully on HIV medication are non-infectious (although science is waiting for the statistical confidence intervals to improve) the data trend is now well established (HPTN052, PARTNER Study) we have zero/no linked infections from a person with undetectable viral load.

Many people with HIV and the people who love them are frustrated and angry with the current HIV medication paradigm, where people are condemned to lifelong HIV medication. It appears as though the urgency to cure HIV has waned given that almost 95% of people are on benign drugs and expected to live an almost normal life expectancy. Extremely grateful as most people with HIV are, it is easy to look over the fence with envy at advancements in other areas of health like Hepatitis C where almost all can now be cured.

HIV cure research is already beginning to inform us that early treatment facilitates HIV remission and reduces significantly the total amount of HIV that hides and gets into our cells (viral reservoir) and for some like in the VISCONTI Cohort a ‘functional cure’ ( a very low viral load without medication). The word “cure” can illicit emotional responses, some of us are comfortable with a ‘social cure’ (free from HIV discrimination) others are happy with a ‘cure in transmission’ (we have this now when people are successfully on HIV medication with undetectable viral load), but mostly we want HIV remission and aspire to a “full cure” (also known as ‘sterilising cure’ where HIV is eliminated from the body permanently).
To encourage a healthy pipeline of HIV cure research the community will need to activate and build the political urgency and momentum to “END HIV”. If you would like to assist or remain informed of future community events around HIV Cure Research please contact me

PositiveAdvocate@hotmail.com When do want a cure “NOW!”

Hate Condoms? Ethical Choices Now Include Truvada

Pills to prevent HIV are a must if we are to end HIV, hurry up and get on board!                         The article below was first published in the November 2014 issue of OutinPerth.

Hate Condoms? Ethical Choices Now Include Truvada
Striking revelations occurred last month. Two separate studies on the effectiveness of Truvada to prevent HIV were stopped prematurely, because early results were so good that having untreated participants became unethical.

Truvada is a HIV medication currently used to treat people with HIV. Truvada pills are currently being studied in HIV negative participants as a way of preventing HIV infection, this strategy is known as PrEP (Pre Exposure Prophylaxis).

The PROUD trial is the first of the studies to announce to all participants the opportunity to take up PrEP. The study was set up to discover if the benefit of taking Truvada (daily dosing, single pill) by negative guys would be cancelled out by men using condoms less or not at all. So 545 men were randomised into two groups, all participants were offered regular STI testing, condoms, safer sex support and behavioural survey and monitoring. However one group received Truvada immediately and the second group deferred treatment with Truvada by a year. Although the official results of the study are not expected until early 2015 the results were so effective in the Truvada group, that it triggered an ethical threshold set before the study began, now everyone in the study has been offered Truvada for PrEP.

The second trial titled IPERGAY (400 participants) is exciting because instead of daily dosing of Truvada it attempts an “on-demand” strategy for taking Truvada, which is more applicable to the real world. This study set up to discover how effective Truvada would be if you took two pills 24hours before when you thought you were going to have sex or a minimum of 2hours before (e.g. on a Friday for Saturday night sex). Then, a daily single pill dosing while your shagging away (e.g. for some virile men this could last a week), when you think your finished take two final does 24hrs apart. Mmm Lets make this strategy a bit simpler, essentially before you have sex have some Truvada in your blood system, while romping maintain Truvada in your blood system by daily dosing, when your finished dose yourself for another two days. Simpler still, take Truvada 1day before, during and two days after you actually had sex (2+1+1+1). I think overtime the creativity of gay men will finesse this prevention strategy further. Importantly the effectiveness of Truvada in the trial again triggered the study’s ethical threshold and all participants were offered Truvada.

In the US Truvada has already been approved for the purpose of HIV prevention in gay men who are negative. This happened after the iPrEx trial , and subsequently iPrEx OLE trial both demonstrated 100% effectiveness of Truvada in preventing HIV if you had sufficient amounts of Truvada in your blood. This equated to a minimum of taking Truvada (single pill daily dosing) 4 times a week.

What does this mean for Australia gay men? Currently Truvada is legal and can be purchased at penthouse prices privately through your friendly HIV medication prescribing GP. There are some Australian PrEP trials (e.g. VicPrEP) currently underway to confirm the feasibility and science of introducing PrEP in Australia. Participants of PrEP trails get access to Truvada for free. If like Gough Whitlam you believe in free universal health care for everyone then “it’s time” to advocate on behalf of sexually active gay man. We have a right to choose our preferred method of HIV protection. Next time you attend STI testing start demanding access to Truvada.

The business case is also favourable for using Truvada as a strategy in a targeted way. Consider the simple life time cost of treating someone with HIV ( e.g. 40+years multiplied by $15,000 per year for HIV medication) $600,000 times approximately 1000 new infections every year, that’s $600 million potentially added to the PBS every year. Now consider targeted Truvada to the 1% of highly active gay men (e.g. 2200 times $15000 per year) $33million per year. These highly sexually active men would only have to prevent 55 new infections per year for the government to break even on its investment. These inaccurate playful numbers would not stand up against health economist scrutiny, however the maths is accurate enough to make the point that investment in HIV prevention and HIV cure research creates a massive public health return in time.

Preventable infections with targeted Truvada as PrEP could make a significant dent in the Australian HIV epidemic. Given the international science, delays in the introduction of targeted Truvada is not only potentially unethical it could also be described as a material systemic failure of public health policy in Australia. Some people who struggle with condoms and acquire HIV, would every right to become extremely angry at having been denied Truvada as a prevention option.

Facing the Ice Challenge to Reduce HIV

If we are to end HIV in Australia facing the Ice challenge will be essential. This article was first published in OutinPerth Oct 2014.

Facing the Ice Challenge to Reduce HIV

Cipriano Martinez

Take notice, 85% percent of men believe ice significantly contributed to behaviour which led to acquiring HIV.

Although this recently reported survey study of 200 people, conducted by the Prahran Market Clinic (Melbourne) can at most only be suggestive because of the very small numbers. For the 65 respondents, who were diagnosed with HIV between 2011-13, the negative consequences of ice behaviour is clear.

Dr Eu, who is located at the clinic explained that using ice (Crystal Methamphetamine) can lower inhibitions and remove the ability to make rational decisions.

The profile screen pages of Perth’s hook up scenes online and on mobile apps frequently make reference to chem sex, wired, party n play (pnp), cannabis (420), oh and lets not forgot the amyl guy too.

Suffice to say that gay boys have been using substances well before HIV came onto the scene in the early eighties. There are many varied reasons why people use alcohol and other drugs, though predominantly it’s used for sex, and the complexity of meaning and emotion attached to the experience, like desire, intimacy, connection, pleasure, to be lost in a moment, to be in control or out of it.

The UK recently highlighted the connection between recreational drugs, sex and living with HIV, in a study called ASTRA (Antiretroviral, Sexual Transmission Risk and Attitudes).

In this large study of 2248 people with HIV, almost 70% where men who had sex with men, most of whom identified as gay, found that 7% of respondents had used ice in the past 3 months. Approximately 38% of all study participants had a detectable viral load (more than 50 HIV copies per millilitre of blood).

The Australian Research Centre in Sex, Health & Society, through HIV Futures Seven, reported that of 1058 participants, 83% where gay men, 16.5% had used ice in the last 12 months (question time frames may explain some of the Ice use differences between the UK & Australia). In HIV futures approximately 15% had a detectable viral load. Although the Kirby Institute, reporting on 2328 people with HIV from the Australian HIV Observational Database estimate 39% of people with HIV have a detectable viral, similar to the UK’s ASTRA study.

So, to reduce HIV what could we do to assist neg and poz guys who use substances with sex. One option is to encourage and prescribe the before pill (Truvada, for Pre Exposure Prophylaxis) to neg guys who use substances like ice during sex. The IPrEx OLE trial found that if neg guys took Truvada at least 4 times a week and preferably daily (as prescribed), then HIV was prevented 100% of the time. Similarly for guys with HIV who use substances with sex, if they begin HIV treatments and successfully maintain an undetectable viral load , then they optimise protection for their partners, especially in the context of an inconsistent condom practice because of substance use. Furthermore we could distribute and promote harm reduction information about how to use drugs more safely and promote gay friendly drug counselling and treatment programs for the small proportion of guys who struggle to manage their substance use and risk harm.

If you’re seeking inspiration search online for Steven Strafford, he is the writer and performer of Methtacular!, which is a musical comedy on addiction. In an interview by Mark S. King he says ” it’s the telling that helps, it’s the talking, it’s the shining light in the darkest places, in the places that no one should ever see or no one will ever love us, and what I’ve found is the opposite, the more you shine light in those places the more opportunities you have for real love”.

Almost all of us use substances in our life time. Substance users are our lovers, our partners, our casual encounters, they are part of our tribes, part of our families part of our communities. Take up the opportunity for real love.

Cipriano Martinez

 

Before Pills: PrEP Drives A Gay Sex Revolution

The before pills to prevent HIV are definitely part of the mix to ending HIV. The article below was first published in the September 2014 issue of OutinPerth Enjoy🙂

Positive Advocate: PrEP Drives A Gay Sex Revolution

Cipriano Martinez

Which study was talked about more than any other at the AIDS 2014 Melbourne Conference? No, I’m not making this up, it was titled ‘iPrEx OLE!’, although I am happy to discuss the results over tapas and sangria.

Would you believe 1603 people were offered the chance to take the before pills Truvada, known medically as Pre Exposure Prophylaxis (PrEP). 1225 took up the challenge, the rest declined. After following everyone for 72 weeks (almost a year and half), no one who took Truvada as prescribed (a daily single pill) or for at least 4 times a week, acquired HIV. That’s right if you took Truvada as a before pill at least 4 times a week it was 100% effective. While approximately 13 guys from the 378 who didn’t take part in the study unfortunately acquired HIV, which equates to an annual incidence rate of 2.6%.

The World Health Organisation in July 2014 published new guidelines. The new PrEP recommendation constitutes a change from a conditional recommendation for PrEP use in demonstration projects to a strong recommendation endorsing PrEP as part of a package of prevention services for men who have sex with men.

The US has already approved the before pill (Truvada for PrEP). Recently Michael Lucas, founder/CEO of Lucas Entertainment, one of the largest porn film makers in New York revealed he was in a poz-neg relationship with Tyler Helms. The couple’s HIV prevention strategy of choice is for Michael to take the before pill consistently and Tyler to be successfully treated with HIV medication (a sustained HIV viral load like this is undetectable).

Love and the desire for intimacy is driving the personal pleasure and safety choices of some gay men. For pos-neg couples the additional protection of having their HIV negative partner on the before pill is transformational, facilitating the additional confidence needed for some to enjoy sex without taking perceived unnecessary risks to achieve closeness.

Many poz-neg couples have for years successfully relied only on undetectable viral load too prevent HIV transmission and are happy to continue this path.

When you consider the casual sex context, now guys who are HIV negative have another option on how to take personal responsibility for their sexual health and prevent HIV. Anxiety over condom slip ups will become significantly diminished and perhaps disappear altogether.

The before pill (Truvada, PrEP) has only just begun to radically change the sexual lives of gay men around the world. Liberating them from the fear of acquiring HIV from the unknown, untested, and unable or unwillingly condom users. The before pill to prevent HIV has the potential to protect other at risk populations too.

There will be some who will attempt to politicise, moralise and gate keep the introduction of the before pill to prevent HIV in much the same way as the contraceptive pill to prevent pregnancy was once heavily debated and stigmatised.

In the US this has already occurred, with terms like “Truvada whore” initially used to shame guys and discourage them from using their protection of choice. There may even be a few gay man who through personal experience and losses from HIV find this novel strategy to prevent HIV to confronting and prefer instead the comfort of the status quo and a singular drum beat, consistent condom use for all for all time.

Some, as reported by Peter Staley on his blog at POZ, have even taken to perverse and disgraceful tactic of pretending to have taken Truvada and described online a false failure. However I have complete confidence that effective science and the freedom to choose your own density will triumph over denial, delays and destructive misinformation.

Where to next? Be sure to let your local doctor, nurse, community worker, politician, whomever might assist know, that you have the right to protect yourself from HIV and demand access to the before pills (Truvada for PrEP), a gay sex revolution and the ending of the HIV epidemic is possible, when we turn to empower and respect each other’s informed choices.

Cipriano Martinez

Read more from Cipriano at positiveadvocate.com

We Can End The HIV Epidemic First In Australia

At the end of the 2014 AIDS Conference in Melbourne I was interviewed by The Age. I describe how Australia has the tools to end the HIV Epidemic now (worth sharing). What a wonderful legacy we could be leaving the world. To my brothers and sisters around the world thank you for your inspiration and love🙂

The Age Australia has the tools to end the HIV epidemic first

Sydney Morning Herald Australia has tools to end the epidemic