It's good news that new HIV cases are declining.  Hopefully this trend will continue as medicine advances. As mentioned above, PREP is affordable and easily accessible to both Thais and foreigners at Pulse Clinic (and elsewhere in Thailand). I've started using it after some initial hesitance after some friends had good experience with it.

 

I've noticed a couple things though. Young Thai guys in their 20s (perhaps like others in that age range globally) don't have the same "fear" of contracting HIV as older guys. My experience dating non-moneyboys is they often prefer not to use condoms. On the other hand, I can't remember a moneyboy who didn't insist on using a condom.

 

There also are still a lot of guys who engage in "PNP" and that is a recipe for disaster. 

I can understand everyone wants to reduce the risk of exposure to HIV. I have never used PREP because I still dont like the odds. 92% is definitely not complete coverage. Even 98% effectiveness still leaves a window. A small one, but it is still there. I assume it means that 2 out of 100 who are involved in bareback sex where one is HIV+ may end up with the virus. Not quite Russian roulette perhaps, but not for me.

I believe that they get their antiviral drugs for free, but I very much doubt that they get paid to take them by the government. Just to put that into perspective, many Thais who work full-time don't earn those 15,000 baht per month you've mentioned.

Maybe he meant 1500 baht. That would definitely make more sense.

 

The two guys I know who are positive are still working. They used to work at the same bar, where the other boys would refuse to do a threesome. Now one has moved to another bar down the road.

 

Condom or not, I'm not going to have sex with them, that's for sure.

I can understand everyone wants to reduce the risk of exposure to HIV. I have never used PREP because I still dont like the odds. 92% is definitely not complete coverage. Even 98% effectiveness still leaves a window. A small one, but it is still there. I assume it means that 2 out of 100 who are involved in bareback sex where one is HIV+ may end up with the virus. Not quite Russian roulette perhaps, but not for me.

 

The only thing that provides complete coverage is abstinence.

 

Prep reduces the risk of contracting the HIV virus by 92-98%. That is more efficient than condoms, which according to the CDC lowers the risk on average by 80%.

 

Theoretically, you are in other words better off barebacking with Prep than using condoms.

 

If you don’t like the odds, but still want to have sex, you should continue to use condoms AND go on Prep.

 

Having said that, the chances of contracting the virus are not as big as many believe. If you have sex with an infected person who is not treated with antiviral drugs the risk ranges, according to the CDC, from 0,1% (if you are a circumcised top) to 1,4% (if you bottom for an uncircumcised top). Reduce those odds by 90+%, and having sex with a MB is probably less dangerous than stepping into a tuk-tuk in the busy streets of Bangkok.

 Reduce those odds by 90+%, and having sex with a MB is probably less dangerous than stepping into a tuk-tuk in the busy streets of Bangkok.

 

There are here some who are enchanted with riding a tuk-tuk, but I would prefer to have sex with a MB even if the odds were the same... 

I'm with a447a on this one, I wouldn't knowingly have sex with anyone who's HIV positive, although the odds strongly suggest that I must have had sex - with condom - with many HIV guys in my 10+ years in Bangkok.

 

Let's use a passenger van analogy: I know that many van drivers take drugs to keep them awake. Still I use vans every now and then, when it's the most convenient mode of transport. But I wouldn't knowingly board a van whose driver I saw taking drugs, even if seatbelts are provided.

Prep reduces the risk of contracting the HIV virus by 92-98%. That is more efficient than condoms, which according to the CDC lowers the risk on average by 80%.

I cannot find this statistic anywhere on the CDC website. I wonder where you got it from because it is totally incorrect. The CDCs website is very clear -

 

Consistent and correct use of latex condoms is highly effective in preventing sexual transmission of HIV, the virus that causes AIDS. The failure of condoms to protect against STD/HIV transmission usually results from inconsistent or incorrect use, rather than product failure.

https://www.cdc.gov/condomeffectiveness/brief.html

 

The key point is "consistent and correct use".

 

AIDS Chicago estimates that condoms are 98%-99% effective in preventing HIV transmission.

 

http://www.aidschicago.org/resources/legacy/condoms/ltoyw_fact.pdf

 

The other benefit of condoms is their effectiveness is preventing the spread of other STDs. And there are a lot of them around! PREP will not do that for you!. This from aids.gov

 

If I am on PrEP (taking antiretroviral medicines to prevent HIV), can I stop using condoms?

No, you should not stop using condoms because you are taking PrEP. If PrEP is taken daily, it offers a lot of protection against HIV infection, but not 100%. Condoms also offer a lot of protection against HIV infection if they are used correctly every time you have sex, but not 100%. PrEP medicines don’t give you any protection from other infections you can get during sex (like gonorrhea, chlamydia, and hepatitis), but condoms do. So you will get the most protection from HIV and other sexually transmitted diseases (STDs) if you consistently take PrEP medicine and consistently use condoms during sex.